仲婷婷,张耀元,王欢欢,孙凡,张淑娟,薛茜,邹玉安
ZHONG Tingting,ZHANG Yaoyuan,WANG Huanhuan,SUN Fan,ZHANG Shujuan,XUE Qian,ZOU Yu'an

• 1:河北北方学院附属第一医院神经内科
• 2:承德医学院附属医院神经内科

摘要(Abstract)：

目的 分析血小板最大聚集率(MAR)与急性脑梗死合并2型糖尿病患者神经缺损程度及预后的相关性。方法 120例急性脑梗死患者根据是否合并2型糖尿病分为合并糖尿病组(病例组，n=60)及未合并糖尿病组(参照组，n=60),病例组根据其美国国立卫生研究所卒中评分量表(NIHSS)评分分为轻度、中度、中重度、重度神经功能缺损程度组，根据预后情况又分为预后良好组和预后不良组；另外选择同期60例健康体检者作为正常对照组；比较病例组、参照组发病48 h内及正常对照组体检时的MAR、空腹血糖(FBG)及糖化血红蛋白(HbAlc)水平；比较病例组患者不同时间点(发病48 h、发病第7天及发病3个月)的MAR水平，比较病例组中不同神经功能缺损亚组和不同预后亚组的MAR水平，并分析病例组MAR水平与FBG、HbAlc、NIHSS评分及mRS评分的相关性。结果 MAR、FBG及HbAlc水平比较，病例组>参照组>正常对照组，差异有统计学意义(P<0.05);病例组患者发病后不同时点MAR水平比较，发病48 h>发病第7天>发病3个月，差异有统计学意义(P<0.05);病例组不同神经功能缺损程度的MAR水平比较，轻度<中度<中重度<重度，差异有统计学意义(P<0.05);病例组预后不良者的MAR水平高于预后良好者，差异具有统计学意义(P<0.05);病例组患者的MAR水平与FBG、HbAlc水平及NIHSS、mRS评分均呈正相关(P<0.05)。结论 MAR与急性脑梗死合并2型糖尿病患者神经功能缺损及远期预后相关，可反映患者预后及病情严重程度。
Objective To analyze correlation between maximal aggregation rate(MAR) of platelets and the degree of neurological deficit and prognosis of patients with acute cerebral infarction(ACI) complicated with type 2 diabetes mellitus. Methods A total of 120 patients with ACI were divided into case group(with diabetes, n=60) and reference group(without diabetes, n=60) according to whether they had type 2 diabetes. Case group was further divided into mild, moderate, moderate to severe and severe neurological deficit subgroups according to National Institute of Health Stroke Score Scale(NIHSS) score. Case group was divided into good prognosis and poor prognosis subgroups according to the prognosis. In addition, 60 patients with healthy examination results in the same period were selected as normal control group. MAR, fasting blood sugar(FBG) and hemoglobin A1c(HbA1c) were compared among case and reference groups within 48 hours of onset and normal control group from physical examination. MARs were compared at 48 h, on 7~(th) day and 3 months after the onset in case group. In case group, MARs were compared among different subgroups of neurological deficits and among different prognosis subgroups. The association of MARs with FBG, HbAlc, NIHSS scores, and mRS scores were analyzed in case group. Results The order of MAR, FBG and HbAlc was case group greater than reference group greater than normal control group(P<0.05). In case group, MAR at different time points after the onset showed a statistically significant difference(P<0.05), with 48 hours of onset greater than 7 days of onset greater than 3 months of onset. In neurological deficit subgroups in case group, MAR showed a statistically significant difference(P<0.05), with the order of MAR was mild subgroup less than less than moderate subgroup less than moderate to severe subgroup less than severe subgroup. In case group, MAR was higher in poor prognosis subgroup than that in good prognosis subgroup(P<0.05). In case group, MAR was positively correlated with the levels of FBG and HbAlc, NIHSS score, and mRS scores(P<0.05). Conclusion MAR is associated with the neurological deficit and long-term prognosis of the patients with ACI complicated with type 2 diabetes mellitus. MAR can reflect the prognosis and severity of the disease.

关键词(KeyWords)： 血小板最大聚集率;2型糖尿病;急性脑梗死;血糖;神经功能缺损;相关性
maximal aggregation rate;type 2 diabetes mellitus;acute cerebral infarction;blood glucose;neurological deficit;correlation

Abstract:

Keywords:

基金项目(Foundation): 河北省2019年度医学科学研究课题计划项目(20190880);; 张家口市级科技计划项目(1921128H)

作者(Author): 仲婷婷,张耀元,王欢欢,孙凡,张淑娟,薛茜,邹玉安
ZHONG Tingting,ZHANG Yaoyuan,WANG Huanhuan,SUN Fan,ZHANG Shujuan,XUE Qian,ZOU Yu'an

DOI: 10.19367/j.cnki.2096-8388.2023.07.015

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