| At present,ischemic cerebrovascular disease is still one of the three deadly diseases that endanger the health of the people.With the continuous development of the global aging process and the extension of life expectancy,the incidence of ischemic cerebrovascular disease continues to rise.Cerebrovascular disease has the characteristics of high incidence,high mortality,high disability rate,high recurrence rate and gradually younger,which seriously affects the health of our people,and has caused serious social and family burden.Therefore,the prevention and treatment of ischemic cerebrovascular disease is an urgent issue for scholars and scientists at home and abroad.Diabetes mellitus is generally considered to be one of the most important risk factors for cerebrovascular disease.Glycated hemoglobinA1 c is the product of the non enzymatic reaction between hemoglobin and glucose or other sugars,which is the “gold standard” for the evaluation of diabetes mellitus.Research shows that poor glycemic control before stroke(i.e.high HbA1 c level)is positively related with the occurrence of ischemic stroke,through a variety of mechanisms to promote the formation of atherosclerosis,is an independent risk factor for ischemic stroke and is easier to lead the posterior circulation ischemic stroke.In this study,we observed the correlation between the level of serum glycosylated hemoglobin(HbA1c)with the severity of posterior circulation vascular disease,the degree of neurological deficit,the progression of the disease and the prognosis,objective to investigate the role of glycosylated hemoglobin in the development of cerebral infarction.This is a retrospective study.A total of 119 patients with acute posterior circulation cerebral infarction in Xingtai People’s Hospital of Hebei province from December 2014 to March 2016 were collected,all the patients’ clinical manifestations met the diagnostic criteria for acute ischemic stroke in China in 2010 and were confirmed by MRI.All the cases were collected with gender and age,medical history,smoking,blood pressure,triglyceride,cholesterol,low density lipoprotein cholesterol,homocysteine,fasting blood glucose,glycosylated hemoglobin,CTA or DSA,NIHSS,30 days of mRS score,whether progress etc.They were divided into three groups: Group normal: HbA1c<6.5%(n= 60),Group mildly elevated:(6.5% ~ 8.5% n =33),and Group Severe elevated: HbA1c≥8.5%(n=26),based on the glycated hemoglobin levels.The general situation,laboratory tests,blood vessel stenosis degree,NIHSS score,30 days of mRS score and the disease progression of the three groups were compared.There was no significant difference between the three groups in general situation;The difference was statistically significant in the history of diabetes mellitus,new onset diabetes mellitus and the first fasting blood glucose(P<0.05).The degrees of vascular stenosis in the three groups were mild : 61.7%,12.1%,3.8%;moderate: 13.3%,42.4%,50%;severe: 25%,45.5%,46.2%.With the increase of HbA1 c level,the proportion of mild stenosis gradually decreased,while that of moderate to severe stenosis gradually increased(P<0.01,T=23.020).Linear analysis showed a linear correlation between HbA1 c levels and the degree of vascular stenosis(x2 = 20.053,P<0.01,R=0.495).The effect of HbA1 c level below 8.5% on admission NIHSS score was relatively small,while Higher than 8.5% Severe elevated group compared with normal,mildly elevate two groups were significantly different(P<0.05).The discharge NIHSS score and mRS score increased with the increase of HbA1 c level,among the three groups showed that the differences were statistically significant(P<0.05).With the increase of HbA1 c level,The proportion of progress in normal,mildly elevate and Severe elevated group increased gradually(P<0.05),and the level of HbA1 c with the progress of the disease was linearly correlated(x2=26.606,P<0.01,R=0.431).Study shows : HbA1 c and posterior circulation cerebral infarction patients were closely related to the degree of vascular atherosclerotic stenosis,and with the increase of HbA1 c level,the patient’s condition is much easier to get worse,and the prognosis is much poorer. |
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