HbA1c水平与脑出血合并糖尿病患者迟发性脑水肿的相关性研究

Correlation of HbA1c value with severity of delayed cerebral edema in patients with ICH complicated with diabetes

摘要:

探讨HbA1c 水平与脑出血合并糖尿病患者迟发性脑水肿的相关性。方法回顾性分析115例于唐山市工人医院神经外科住院的脑出血合并糖尿病患者。采用HPLC 法检测HbA1c，根据HbA1c 水平分为HbA1c<7.0%组（A 组）、7.0%～9.0%组（B 组）和HbA1c>9.0%组（C 组），分析HbA1c 水平对脑出血合并糖尿病患者迟发性脑水肿的影响。结果3 组迟发性脑水肿发生率差异有统计学意义（ p<0.05）；脑出血合并糖尿病发生迟发性脑水肿患者水肿体积与HbA1c（r =0.814，p =0.000）、GCS 评分（r =-0.780，p =0.000）、NIHSS 评分r（ =0.696， p=0.000）均相关；多元线性回归分析后，HbA1c 与患者水肿体积仍相关（β=0.741，t=5.280，p =0.000）。结论HbA1c水平与脑出血合并糖尿病患者迟发性脑水肿严重程度相关。

Abstract:

To explore the correlation between glycated hemoglobin A1c (HbA1c) value and the severity of delayed cerebral edema in patients with intracerebral hemorrhage (ICH) complicated with diabetes. Methods A total of 115 patients of ICH complicated with diabetes hospitalized in Tangshan Gongren Hospital were retrospectively analyzed and divided into three groups: group A (HbA1c < 7.0%), group B (7.0% ≦HbA1c ≦9.0%), and group C (HbA1c > 9.0%) according to HbA1c level. High-pressure liquid chromatography (HPLC) was adopted to detect HbA1c. Glasgow Coma Scale (GCS) and the US National Institutes of Health Stroke Scale (NIHSS) were used to assess patients' condition. Then the influence of HbA1c on delayed cerebral edema in the ICH patients was analyzed. Results The incidence of delayed cerebral edema was significant different among the three groups (all< 0.05). Edema volume of the patients with delayed cerebral edema was correlated with HbA1c, GCS and NIHSSscore ( r= 0.814, -0.780 and 0.696 respectively; all p= 0.000). Furthermore, HbA1c level was still correlated with the edema volume in multiple linear regression analysis (β= 0.741, t= 5.280, p= 0.000). Conclusions HbA1c level is correlated with the severity of delayed cerebral edema in patients with intracerebral hemorrhage complicated with diabetes.