CAJ | 학술논문

目的探讨血糖、血脂等因素对2型糖尿病(DM)患者脑白质疏松(LA)严重程度的影响. 方法选取参加2010年我国华南地区脑卒中并发偏瘫的综合防治的多中心研究的106例2型DM并皮质下血管性痴呆(SVD)患者,静脉抽血检测糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2h血糖(2HPG)、甘油三脂(TG)、总胆固醇(CHOL)、高密度脂蛋白(HDL)和低密度脂蛋白(LDL)；行头颅MRI检查,对皮质下白质高信号影(DWMH)和脑室周围白质高信号影(PVH)严重程度进行分级(1级、2级、3级).并应用半定量方法计算LA分数.多重线性回归分析LA分数的影响因素;比较不同HbA1c水平患者的临床特征；分析DWMH程度和PVH程度与其他因素的相关性并比较不同DWMH和PVH程度组患者的临床特征. 结果患者LA分数与HbAIc、年龄呈正相关关系(r=0.457,P=0.000; r=0.400,P=0.000),多重线性回归分析LA分数会随HbA1c、年龄的增加而增加(P＜0.05)；不同HbA1c水平患者LA分数不同,差异有统计学意义(P＜0.05); DWMH程度和PVH程度分别与HbA1c、年龄呈正相关关系(r=0.385,P=0.000,r=0.361,P=0.000；r=0.458,P=0.000,r=0.364,P=0.000),不同DWMH和PVH程度组间比较脑卒中史患者比例不同,差异有统计学意义(P＜0.05),校正年龄的影响后,DWMH程度和PVH程度均与HbA1c水平呈正相关关系(r=0.253,P=0.009;r=0.318,P=0.001). 结论血清HbA1c水平是反映2型DM患者大量LA(包括DWMH、PVH)的重要生化指标.年龄、卒中史与2型DM患者LA严重程度有关.未发现血脂水平与2型DM患者大量LA严重程度相关.
목적 탐토혈당、혈지등인소대2형당뇨병(DM)환자뇌백질소송(LA)엄중정도적영향. 방법 선취삼가2010년아국화남지구뇌졸중병발편탄적종합방치적다중심연구적106례2형DM병피질하혈관성치태(SVD)환자,정맥추혈검측당화혈홍단백(HbA1c)、공복혈당(FPG)、찬후2h혈당(2HPG)、감유삼지(TG)、총담고순(CHOL)、고밀도지단백(HDL)화저밀도지단백(LDL)；행두로MRI검사,대피질하백질고신호영(DWMH)화뇌실주위백질고신호영(PVH)엄중정도진행분급(1급、2급、3급).병응용반정량방법계산LA분수.다중선성회귀분석LA분수적영향인소;비교불동HbA1c수평환자적림상특정；분석DWMH정도화PVH정도여기타인소적상관성병비교불동DWMH화PVH정도조환자적림상특정. 결과 환자LA분수여HbAIc、년령정정상관관계(r=0.457,P=0.000; r=0.400,P=0.000),다중선성회귀분석LA분수회수HbA1c、년령적증가이증가(P＜0.05)；불동HbA1c수평환자LA분수불동,차이유통계학의의(P＜0.05); DWMH정도화PVH정도분별여HbA1c、년령정정상관관계(r=0.385,P=0.000,r=0.361,P=0.000；r=0.458,P=0.000,r=0.364,P=0.000),불동DWMH화PVH정도조간비교뇌졸중사환자비례불동,차이유통계학의의(P＜0.05),교정년령적영향후,DWMH정도화PVH정도균여HbA1c수평정정상관관계(r=0.253,P=0.009;r=0.318,P=0.001). 결론 혈청HbA1c수평시반영2형DM환자대량LA(포괄DWMH、PVH)적중요생화지표.년령、졸중사여2형DM환자LA엄중정도유관.미발현혈지수평여2형DM환자대량LA엄중정도상관.
Objective To investigate the relationships between the risk factors (the levels of blood glucose and blood fat) and the severity of leukoaraiosis (LA) in patients with type 2 diabetes.Methods The risk factors (including levels of plasma HbA1c,fasting blood glucose,2 hours blood glucose after meals,triglyceride,total cholesterol,high density lipoprotein,and low density lipoprotein) were measured and the head magnetic resonance were used in the selected patients who were diagnosed as having subcortical vascular dementia and type 2 diabetes (n=106).According to the Fazekas's classification of signals of deep white matter hyperintense (DWMH) and periventricular hyperintense (PVH),the severity of LA was graded as grade 1,2 and 3 by its appearance under MRI.LA scores were obtained by its appearance under MRI according to the semiquantitative way; the influencing factors of LA scores were analyzed using multiple linear regression.The clinical features of patients with different plasma HbAlc levels were compared; the relations of signals of DWMH and PVH with other risk factors were compared; and the clinical features of patients with different signals of DWMH and PVH were compared too.Results LA scores were positively related to HbAlc level and age (r=0.457,P=0.000;r=0.400,P=0.000).The signals of DWMH and PVH were positively related to the HbA1c level and age (r=0.385,P=0.000; r=0.361,P=0.000; r=0.458,P=0.000; r=0.364,P=0.000).Statistical significance of stroke history in different signals of DWMH and PVH was noted (P＜0.05).After adjusting the age,signals of DWMH and PVH were positively correlated to the HbA1c level (r=0.253,P=0.009; r=0.318,P=0.001).Conclusion In the patients with type 2 diabetes,the plasma level of HbA 1 c is an important biochemical indicator which reflects the severity of LA (including DWMH and PVH); age and stroke history are relative with the severity of LA,while blood fat level is not correlated to the severity of LA.