D - D 二聚体水平联合糖化血红蛋白对脑小血管疾病病情的预测效果

摘要

目的：探讨 D - D 二聚体水平联合糖化血红蛋白对脑小血管疾病病情的预测效果。方法选取2012年1月至2014年12月期间住院治疗的脑小血管病患者150例，根据患者的脑动脉脉动指数（PI）的差别将患者分为高 PI组（PI ﹥1.5，n =49）、中 PI 组（1.2≤PI≤1.5，n =66）、低 PI 组（PI ﹤1.2，n =35）。另选健康对照组50例。所有观察对象检测 D - D 二聚体、糖化血红蛋白、PI、血压、体重、身高等基本资料，比较4组的血样中 D - D 二聚体、糖血红蛋白的差异；再通过多因素 Logistic 回归分析确定脑小血管病的危险影响因素，分析糖化血红蛋白与 D - D 二聚体含量与脑血小血管疾病病情的关系。结果随着脑小血管疾病病情的加重，患者的 D - D 二聚体水平和糖化血红蛋白水平明显升高。4组研究对象的 D - D 二聚体和糖化血红蛋白含量的差异具有统计学意义，组间两两比较均具有统计学差异；D - D 二聚体含量、糖化血红蛋白含量均为脑小血管疾病的危险因素；通过 Pesrson 相关性分析显示，糖化血红蛋白含量与脑小血管疾病病情的严重程度呈正相关（ r =0.669，P =0.013；D - D 二聚体含量与脑小血管疾病病情的严重程度呈正相关（ r =0.683，P =0.010）。结论脑小血管疾病的严重程度与 D - D 含量和糖化血红蛋白含量存在正相关性，在临床上可以通过 D - D 二聚体含量和糖化血红蛋白含量来一定程度上预测脑小血管疾病的病情。%Objective To discuss the prediction effect of D - D combined with glycated hemoglobin level of cerebral small vessel disease. Methods This study selected 150 cases of cerebral small vessel disease patients during the treatment from January 2012 to December 2014 in our hospital. According to differences in the patient's brain artery pulsatility index(PI),the patients were divided into high,medium and low three sets. The high standards for the PI group of patients in which PI ﹥ 1. 5,this group included 49 patients. The group of patients with PI standard 1. 2≤PI≤1. 5 included 66 patients. Low PI group standards for PI ﹤ 1. 2 included 50 patients. The healthy control group included 50 cases. D - D- dimer,glycosylated hemoglobin,PI,blood pressure,weight,height and other basic information of all patients were detected and compared a-mong the four groups. The other indexes included D - D dimer blood samples,the difference of glycohemoglobin. Multivariate Logistic regression was used to determine the risk of cerebral small vessel disease,and analyze the relationship between glycated hemoglobin and D - dimer and cere-bral small vessel disease condition. Results The difference D - dimer and glycated hemoglobin content of the four groups of the study were statis-tically significant. Pairwise comparisons between groups were statistically difference. D - dimer,glycosylated hemoglobin were small risk factors for vascular disease. Pesrson correlation analysis showed that glycated hemoglobin levels and severity of cerebral small vessel disease of the disease was positively correlated( r = 0. 669,P = 0. 013). D - Dimer and severity of cerebral small vessel disease condition had a positive correlation( r =0. 683,P = 0. 010). Conclusion The severity of D - dimer levels and glycosylated hemoglobin content of cerebral small vessel disease had a positive correlation between clinically by D - Dimer levels and glycated hemoglobin,which can predict disease cerebral small vessel disease to a certain extent.