The Clinical Significance Of Glycated Hemoglobin In The Ischemic Cerebrovascular Disease

Objectives: As all known diabetes is a cardio-cerebrovascular diseaserisk factors, it mainly damage the tiny blood vessels, such as, retinal arterialrenal artery, and can cause myocardial infarction and cerebral infarction andserious complications of diabetes. The early diagnosis and treatment canprevent and reduce the occurrence of heart head blood-vessel. It have a studythat two-thirds of patients who with acute cerebral infarction were found highblood sugar, will diagnose cerebral infarctio in the three months later. Maybethe body's tiny blood vessels have damaged before the diabete. Glycatedhemoglobin is the glycation product of blood glucose and hemoglobin whichcan reflect the nearly2-3month of blood glucose levels. Glucose and proteinenzyme saccharification have very close relationship with the occurrence ofdiabetic angiopathies. Diabetic patients increase protein nonenzymaticglycation reaction in high glucose environment. The higher concentration ofHbA1c can reduce the rate of dissociation caused by hypoxia and Hb, tissuehypoxia; form the basement membrane and vascular wall collagen glycationinduced vascular lesions; serum albumin glycated;accelerate the formation ofatherosclerosis. Lots of advanced glycation end products (AGE) constantlyaccumulat in the vascular wall, eventually leading to stromal hyperplasia,luminal stenosis and thrombosis. Studies suggest that elevated glycatedhemoglobin is an independent risk factor for cardiovascular disease, however,whether glycosylated hemoglobin is the independent risk factors for cerebralinfarction has not clearly in the present. This study is to discuss whetherglycosylated hemoglobin is the risk factor of various types of cerebralinfarction, and to explore the clinical significance of glycosylated hemoglobin.Methods: A consecutive series of acute ischemic stroke patients wereincluded for this analysis from September,2010to November,2011. To screen the risk factors and determinat the glycated hemoglobin of the488patient who meet the criteria.HbA1c was examined on admission, and historyof diabetes was performed for analysis of diabetic group and non-diabeticgroup.Main artery atherosclerotic lesions or small vessel disease wasdiagnosed by MRA or TCD, and small vessel disease was classified as whitematter degeneration, slight bleeding of the brain and old lacunar infarction.Patients with cerebral infarction in the admission and after two weeks oftreatment were measured by the NIHSS score for statistical analysis.Results:488cases of acute cerebral infarction patients start (diabetesgroup213examples, the diabetes group275examples), draw glycatedhemoglobin level with any type of the diabetes cerebral infarction nocorrelation, instead, glycated hemoglobin level and diabetic cerebral infarctionof the artery atherosclerosis cerebral infarction and cerebral white matterdegeneration a strong correlation, a single variable analysis were P=0.01andP <0.05if age and high blood pressure to do more variable factor analysis thislink has not exist but appear, with the increase of age glycosylated hemoglobinlevels falling (P=0.03) glycated hemoglobin levels and diabetes cerebralinfarction of the prognosisConclusions: Our research shows that glycated hemoglobin can't bevarious types of ischemic stroke independent risk factors, but the history ofdiabetes can monitor the prognosis of patients with cerebral infarction, and tofind out if you have diabetes tendency in time to early intervention, have ahistory of diabetes in patients with cerebral infarction glycosylatedhemoglobin level and age negative correlation still needs further study.