老年颈动脉粥样硬化患者糖化血红蛋白和空腹血糖水平与病变严重程度的相关性研究

doi:10.16150/j.1671-2870.2019.01.016

摘要/Abstract

摘要： 目的探讨老年颈动脉粥样硬化患者的糖化血红蛋白及空腹血糖水平与其病变严重程度间的相关性。方法选择2017年5月1日至2018年5月31日在上海交通大学医学院附属瑞金医院卢湾分院老年科住院的144例颈动脉粥样硬化患者，按照血管超声检查结果将其分为颈动脉轻中度粥样硬化组和颈动脉严重粥样硬化组，记录一般情况、相关病史，并计算颈动脉斑块Crouse积分;留取患者入院第二日清晨的空腹血标本，检测糖化血红蛋白、空腹血糖水平并进一步分析，探讨颈动脉粥样硬化病变严重程度与糖化血红蛋白、空腹血糖间的相关性。结果与颈动脉轻中度粥样硬化组相比，颈动脉严重粥样硬化组的空腹血糖[（6.86±1.98） mmol/L比（5.72±1.33） mmol/L，P<0.05]、糖化血红蛋白[（6.47±2.53）%比（5.43±1.24）%，P<0.05]均明显升高。logistic回归分析显示，糖化血红蛋白（r=0.578，P<0.05）、空腹血糖（r=0.479，P<0.05）与颈动脉粥样硬化的严重程度呈正相关。结论老年颈动脉粥样硬化患者的糖化血红蛋白及空腹血糖水平与其颈动脉粥样硬化严重程度显著相关。

关键词: 动脉粥样硬化, 糖化血红蛋白, 血糖, Crouse积分

Abstract:

Objective: To investigate the correlation of glycosylated hemoglobin and fasting blood glucose level with severity of lesion in elderly patients with carotid artery atherosclerosis. Methods: A total of 144 patients with carotid artery atherosclerosis admitted to the Geriatrics Department of Shanghai Ruijin Hospital Luwan Branch from May 1, 2017 to May 31, 2018 were enrolled. According to the results of vascular ultrasonography, patients were categorized into mode-rate atherosclerosis group and severe atherosclerosis group. The general condition and related medical history were recor-ded, and the Crouse score of carotid artery plaque was calculated. On the second day of admission, fasting blood sample was taken to detect glycosylated hemoglobin and fasting blood glucose level. The correlation of glycosylated hemoglobin and fasting blood glucoselevel with severity of atherosclerotic lesion was analyzed. Results: Compared with moderate atherosclerosis group, the fasting blood glucose level [(6.86±1.98) mmol/L vs （5.72±1.33） mmol/L, P<0.05] and glycated hemoglobin [(6.47±2.53)% vs （5.43±1.24）%, P<0.05) of severe atherosclerosis group were significantly increased. Logistic regression analysis showed that glycated hemoglobin (r=0.578, P<0.05) and fasting blood glucose level (r=0.479, P<0.05) were positively correlated with the severity of carotid artery atherosclerosis. Conclusions: Glycated hemoglobin and fasting blood glucose level in elderly patients with carotid artery atherosclerosis are correlated significantly with the severity of carotid artery atherosclerosis.

Key woeds: Atherosclerosis; Glycated hemoglobin; Blood glucose; Crouse integral

中图分类号:

R541.4

黄晓怡, 蔡伟, 舒时珍, 庞小芬. 老年颈动脉粥样硬化患者糖化血红蛋白和空腹血糖水平与病变严重程度的相关性研究[J]. 诊断学理论与实践, 2019, 18(1): 82-85.

HUANG Xiaoyi, CAI Wei, SHU Shizhen, PANG Xiaofen. Correlation of glycosylated hemoglobin and fasting blood glucose level with severity of lesion in elderly patients with carotid artery atherosclerosis[J]. Journal of Diagnostics Concepts & Practice, 2019, 18(1): 82-85.

图/表 2

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参数	颈动脉轻中度粥样硬化组（n=86）	颈动脉重度粥样硬化组（n=58）
男[n（%）]	58（67.44）	36（62.07）
年龄（岁）	67.38±26.15	71.12±23.67
吸烟[n（%）]	44（51.16）	33（56.89）
高血压（%）	56（65.12）	34（58.62）
糖尿病（%）	41（47.67）	31（53.45）
总胆固醇（mmol/L）	3.65±1.73	4.10±1.17
三酰甘油（mmol/L）	1.43±0.69	1.56±0.79
低密度脂蛋白胆固醇（mmol/L）	2.16±0.39	2.33±0.81
高密度脂蛋白胆固醇（mmol/L）	1.18±0.26	1.16±0.27
空腹血糖（mmol/L）	5.72±1.33	6.86±1.98^a)
HbA1c（%）	5.43±1.24	6.47±2.53^a)
Crouse积分（分）	3.24±1.46	6.62±1.29^a)

项目	Crouse积分
项目	r值	P值
年龄	-0.010	>0.05
性别	0.074	>0.05
吸烟	0.129	>0.05
高血压	0.314	>0.05
糖尿病	0.138	>0.05
总胆固醇	0.178	>0.05
三酰甘油	-0.084	>0.05
低密度脂蛋白胆固醇	0.124	>0.05
高密度脂蛋白胆固醇	-0.120	>0.05
空腹血糖	0.479	<0.01
HbA1c	0.578	<0.01