CAJ | 학술논문

目的：探讨2型糖尿病（T2MD）患者空腹血糖水平对新发缺血脑卒中的影响。方法以2012年6月至2014年6月收治的168例 T2MD 患者为研究对象，根据患者头部 CT 诊断结果将患者分为 T2MD 无缺血脑卒组（T2MD组）82例以及 T2MD 合并缺血脑卒中组（合并脑卒中组）86例，另选取80例正常体检者为对照组。分别测定三组体重指数（BMI）、空腹血糖值（FBG）、糖化血红蛋白（HbA1C）、空腹胰岛素（FINS）、收缩压（SBP）、舒张压（DBP）、同型半胱氨酸（Hcy）、总胆固醇（TC）、甘油三脂（TG）、低密度脂胆固醇（LDL - C）、高密度脂胆固醇（HDL - C），并计算胰岛素抵抗指数（HOMA - IR）。空腹血糖与各指标的关系应用 Pearson 单因素分析，FBG 与脑卒中的关系应用 Logistic 多因素进行分析。结果 T2MD 组及合并脑卒中组 BMI、FBG、HbA1C、Hcy、FINS、HOMA - IR、TC、TG、LDL - C 水平显著高于对照组（ P ﹤0.05），而 HDL - C 水平则低于对照组（ P ﹤0.05），其中合并脑卒中组 FBG、HbA1C、FINS、HOMA - IR、Hcy、LDL- C 水平显著高于 T2MD 组（ P ﹤0.05）。经 Pearson 单因素分析可知，FBG 与 FINS、HOMA - IR、LDL - C 呈正相关（ P﹤0.05）。经 Logistic 多因素分析显示，FBG、FINS、HOMA - IR、Hcy 是 T2MD 合并脑卒中发生的独立危险因素。结论T2MD 患者空腹血糖水平与新发缺血性脑卒中关系密切，且是脑卒中存在的独立危险因子。通过控制 T2MD 患者空腹血糖水平可有效预防缺血性脑卒中的发生。
목적：탐토2형당뇨병（T2MD）환자공복혈당수평대신발결혈뇌졸중적영향。방법이2012년6월지2014년6월수치적168례 T2MD 환자위연구대상，근거환자두부 CT 진단결과장환자분위 T2MD 무결혈뇌졸조（T2MD조）82례이급 T2MD 합병결혈뇌졸중조（합병뇌졸중조）86례，령선취80례정상체검자위대조조。분별측정삼조체중지수（BMI）、공복혈당치（FBG）、당화혈홍단백（HbA1C）、공복이도소（FINS）、수축압（SBP）、서장압（DBP）、동형반광안산（Hcy）、총담고순（TC）、감유삼지（TG）、저밀도지담고순（LDL - C）、고밀도지담고순（HDL - C），병계산이도소저항지수（HOMA - IR）。공복혈당여각지표적관계응용 Pearson 단인소분석，FBG 여뇌졸중적관계응용 Logistic 다인소진행분석。결과 T2MD 조급합병뇌졸중조 BMI、FBG、HbA1C、Hcy、FINS、HOMA - IR、TC、TG、LDL - C 수평현저고우대조조（ P ﹤0.05），이 HDL - C 수평칙저우대조조（ P ﹤0.05），기중합병뇌졸중조 FBG、HbA1C、FINS、HOMA - IR、Hcy、LDL- C 수평현저고우 T2MD 조（ P ﹤0.05）。경 Pearson 단인소분석가지，FBG 여 FINS、HOMA - IR、LDL - C 정정상관（ P﹤0.05）。경 Logistic 다인소분석현시，FBG、FINS、HOMA - IR、Hcy 시 T2MD 합병뇌졸중발생적독립위험인소。결론T2MD 환자공복혈당수평여신발결혈성뇌졸중관계밀절，차시뇌졸중존재적독립위험인자。통과공제 T2MD 환자공복혈당수평가유효예방결혈성뇌졸중적발생。
Objective To explore the effect of blood level of fasting glucose on new onset of ischemic stroke in patients with type 2 diabe-tes mellitus(T2MD). Methods A total of 128 cases of T2MD during June 2012 to June 2014 were divided into T2MD without ischemic stroke group(n = 82)and T2MD complicated with ischemic stoke group(n = 86)according to their results of cerebral CT scanning,and 80 healthy per-sons were selected as control group. Body mass index(BMI),blood levels of fasting blood glucose(FBG),glycosylated hemoglobin(HbA1C) and fasting insulin(FINS),systolic blood pressure(SBP),diastolic blood pressure(DBP),levels of homocysteine( Hcy),total cholesterol (TC),triglyceride(TG),low - density lipoprotein cholesterol(LDL - C),high density lipoprotein cholesterol(HDL - C),and insulin resist-ance index(HOMA - IR)were measured in patients of these groups. The correlation of plasma level of fasting glucose and respective indices were analyzed with Pearson univariate analysis. The relationship between stroke and FBG had been analyzed with Logistic multivariate analysis. Results Levels of BMI,FBG,HbA1C,Hcy,FINS,HOMA - IR,TC,TG and LDL - C in patients of T2MD group and combined stroke group were sig-nificantly higher than those of control group( P ﹤ 0. 05),whereas level of HDL - C was lower than that of control group( P ﹤ 0. 05),and levels of FBG,HbA1C,FINS,HOMA - IR,Hcy and LDL - C in patients merged with stroke group were significantly higher than those of T2MD group ( P ﹤ 0. 05). Pearson univariate analysis showed levels of FBG,FINS,HOMA - IR and LDL - C were positively correlated( P ﹤ 0. 05). Logis-tic multivariate analysis showed that levels of FBG,FINS,HOMA - IR and Hcy were independent risk factors for mergence of stroke in patients with T2MD. Conclusion Level of fasting glucose in patients with T2MD is closely correlated to the new - onset of ischemic stroke,and it is an independent risk factor for occurrence of stroke in patients with T2MD. The onset of ischemic stroke can be effectively prevented by measuring blood level of fasting glucose and it can be effectively applied for prevention of the occurrence of ischemic stroke.