Acute cerebral infarction patients with type 2 diabetes, blood glucose, glycosylated hemoglobin levels of intravenous thrombolytic therapy effects
LU Shaohuan
ZHANG Jing
CHENG Wanchun
LI Zhipeng
Abstract：Objective To observe the effect of blood glucose (FPG) and glycosylated hemoglobin (HbA1c) level on intravenous thrombolysis in patients with acute cerebral infarction complicated with type 2 diabetes mellitus .Methods From January 2015 to December 2016 , in our hospital , admissions of 96 patients with acute cerebral infarction were given alteplase ( Recombinant tissue plasminogen activator , rt-PA) for thrombolytic therapy study were enrolled , patients were divided into acute cerebral infarction patients with type 2 diabetic group ( DMCI group ) with 50 cases and acute cerebral infarction and non-type 2 diabetes group (NDMCI group) with 46 cases.Using neurological deficit (NIHSS) score, modified Rankin Scale (MRS) score, Barthel index score of patients and determining the patient FPG , glycosylated hemoglobin (HbA1c), triglycer-ide ( TG) , low density lipoprotein cholesterol ( LDL-C) , TC, high density lipoprotein cholesterol ( HDL-C) and other indica-tors , observed DMCI patients before thrombolysis random blood glucose level and HbA 1c value 24h efficacy of thrombolysis;patients were followed up for 3 months after thrombolysis .Results (1) In DMCI group compared with NDMCI group , FPG, HbA1c TG, LDL-C, the difference was statistically significant between two groups (compared within DMCI group:t =2.942, t =6.044, t =2.631, t =8.825;compared within NDMCI group:t =9.223, t =25.178, t =5.343, t =4.731;after treat-ment:t =11.365, t =11.051, t =6.380, t =3.258,all P <0.05).The 2 groups after treatment, the differences of TC, HDL-C were not statistically significant ( t =1.306, t =1.904; P >0.05); (2) In DMCI group 24 h average blood (MBG), SDBG and MAGE were higher than NDMCI group patients [(8.4 ±2.8) mmol/L vs.(5.6 ±1.8) mmol/L, (3.0 ± 0.3) mmol/L vs.(2.2 ±0.4) mmol/L, (4.4 ±0.8) mmol/L vs.(3.6 ±0.5) mmol/L, t =5.772, 11.142, 5.816, P <0.05];(3) Before thrombolysis blood glucose <6.0 mmol/L, 24 h after thrombolysis were the lowest (28.6%), and blood glucose before thrombolysis in 7-9 mmol/L, 24 h after thrombolysis had the highest efficiency (70.6%);(4) Increased grad-ually with the value of HbA1c, 24 h after thrombolysis has low efficiency gradually .The highest value (62.5%) at HbA1c <6.0 mmol/L, and the HbA1c value was more than 7 mmol/L with the lowest (28.6%);(5) After thrombolysis in the DMCI group, NIHSS, MRS score of patients were higher than in NDMCI group , while the Barthel index in patients with DMCI group was lower than that of NDMCI group ( P <0.05); (6) DMCI intracranial hemorrhage after thrombolysis group was higher than that of NDMCI group, but the difference was not significant (χ2 =1.132, P >0.05), but there were significant differ-ences in vascular recanalization and prognosis (χ2 =10.816,χ2 =7.739, P <0.05).Conclusion Thrombolytic therapy in patients with type 2 diabetes mellitus in the acute cerebral infarction , blood glucose levels affect the efficacy of HbA 1c , the higher the value , the effect is worse , and the blood glucose control before thrombolysis in 7-9 mmol/L is helpful to improve the curative effect of intravenous thrombolytic therapy .
Keywords：Cerebral infarctionacuteType 2 diabetesBlood glucoseGlycated hemoglobinIntravenous thrombolysis
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 27-31 )