标题：AIS合并糖尿病患者HbA1c、Hcy、血脂水平及神经功能状况评估

      作者：马亚如，郭艺静，雷华斌    北京中医药大学孙思邈医院脑病科，陕西 铜川 727031

      卷次： 2020年31卷24期

      【摘要】 目的 探讨急性缺血性脑卒中(AIS)合并糖尿病患者糖化血红蛋白(HbAlc)、同型半胱氨酸(Hcy)、血脂水平[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)]及神经功能状况，为其临床预防和治疗提供指导。方法 选取2017年5月至2019年5月期间北京中医药大学孙思邈医院脑病科确诊的55例AIS合并糖尿病患者作为研究组，55例AIS患者作为对照1组，同期在我院体检的健康人员55例作为对照2组，比较三组受检者入院后的HbA1c、Hcy和血脂水平，并对患者入院时和入院14 d后采用美国国立卫生院神经功能缺损评分表(NIHSS)和入院14 d后的改良RINKIN量表(mRS)评估患者的神经功能。结果 研究组患者的Hcy、HbAlc水平明显高于对照 1组和对照 2组，对照 1组患者的Hcy、HbAlc水平又明显高于对照 2组，差异均有统计学意义(P<0.05)；研究组患者的TC、TG、LDL水平明显高于对照1组和对照2组，对照1组患者的TC、TG、LDL水平又明显高于对照 2组，差异均有统计学意义(P<0.05)；研究组患者的HDL水平明显低于对照 1组和对照 2组，对照 1组患者HDL水平明显低于对照2组，差异均有统计学意义(P<0.05)；研究组患者入院时和入院14 d的NIHSS分别为(15.34±4.05)分、(10.32±3.23)分、入院 14 d的mRS为(1.68±0.34)分，明显高于对照 1组的(14.54±6.12)分、(7.38±3.70)分、(1.08±0.40)分，差异均有统计学意义(P<0.05)。结论 AIS合并糖尿病患者HbA1c、Hcy水平明显升高，神经功能缺损程度较重，血脂水平也会发生明显改变，HbA1c、Hcy、血脂水平检测及神经功能状况评估对AIS合并糖尿病患者的临床诊断和治疗具有重要意义。
      【关键词】 急性缺血性脑卒中；糖尿病；同型半胱氨酸；糖化血红蛋白；血脂水平；神经功能
      【中图分类号】 R743.3 【文献标识码】 A 【文章编号】 1003—6350（2020）24—3145—04

Evaluation of HbA1c, Hcy, blood lipid, and neurological function in patients with acute ischemic stroke anddiabetes mellitus.
MA Ya-ru, GUO Yi-jing, LEI Hua-bin. Department of Encephalopathy, Sun Simiao Hospital of BeijingUniversity of Traditional Chinese Medicine, Tongchuan 727031, Shaanxi, CHINA
【Abstract】 Objective To investigate the levels of glycosylated hemoglobin (HbAlc), homocysteine (Hcy),blood lipid (total cholesterol [TC], triglyceride [TG], high density lipoprotein [HDL], low density lipoprotein [LDL]),and neurological function in patients with acute ischemic stroke (AIS) complicated with diabetes mellitus, so as to provideguidance for clinical prevention and treatment of patients. Methods From May 2017 to May 2019, 55 AIS patients withdiabetes mellitus diagnosed in Department of Encephalopathy, Sun Simiao Hospital of Beijing University of TraditionalChinese Medicine were selected as the study group, 55 AIS patients as the control group 1, and 55 healthy people in ourhospital during the same period were selected as the control group 2. The HbA1c, Hcy, and blood lipid levels of the threegroups were compared at admission and 14 days after admission National Institute of Health Stroke Scale (NIHSS) andmodified Rankin scale (mRS) were used to evaluate the neurological function of the patients. Results The levels ofHcy and HbAlc in the study group were significantly higher than those in the control group 1 and 2, and the levels ofHcy and HbAlc in the control group 1 were significantly higher than those in the control group 2 (P<0.05); the levels oftotal cholesterol (TC), triglycerides (TG), and low-density lipoprotein (LDL) in the study group were significantly higherthan those in the control group 1 and 2, and the levels of TC, TG and LDL in the control group 1 were significantly high-er than those in the control group 2, and the differences were statistically significant (all P<0.05); the high-density lipo-protein (HDL) level of the study group was significantly lower than that of the control group 1 and 2, and the HDL lev-el of the control group 1 was significantly lower than that of the control group 2, the differences were statistically sig-nificant (P<0.05); the NIHSS of the study group on admission and 14 days after admission and mRS of the study group14 days after admission were (15.34±4.05) points, (10.32±3.23) points, (1.68±0.34) points, which were significantlyhigher than corresponding (14.54±6.12) points, (7.38±3.70) points, (1.08±0.40) points of the control group 1 (all P<0.05). Conclusion The levels of HbA1c and Hcy in patients with acute ischemic stroke complicated with diabetes mel-litus were significantly increased, and the degree of nerve function defect was relatively serious, and the blood lipid levelwould also change significantly. It is of great significance for the clinical diagnosis of patients with acute ischemic strokecomplicated with diabetes mellitus to detect the levels of HbA1c, Hcy and blood lipid and evaluate the neurological sta-tus. It is worthy of clinical guidance.
      【Key words】 Ac