慢性高血糖对脑微血管重构的影响：急性缺血性脑卒中患者使用灌注 CT 的体内研究。
Influence of chronic hyperglycemia on cerebral microvascular remodeling: an in vivo study using perfusion computed tomography in acute ischemic stroke patients.
机构信息
From the Neuroradiology Division, Department of Radiology (Q.H., Y.Z., F.M., M.W.), Department of Anesthesiology (Z.Z.), and Department of Neurology (K.C.J.), University of Virginia, Charlottesville, VA; Department of Neurology, the Second Affiliated Hospital of Guangzhou Medical University, China (Q.H., Q.G.); Department of Neurology (P.M., A.E.), and Department of Radiology (M.W.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Ultrasound, the Union Hospital of Huazhong University of Science and Technology, Tongji Medical College, Wuhan, China (Y.Z.); and Department of Radiology, the Tongren Hospital of Capital Medical University, Beijing, China (F.M.).
出版信息
Stroke. 2013 Dec;44(12):3557-60. doi: 10.1161/STROKEAHA.113.003150. Epub 2013 Sep 12.
BACKGROUND AND PURPOSE
To investigate the effect of chronic hyperglycemia on cerebral microvascular remodeling using perfusion computed tomography.
METHODS
We retrospectively identified 26 patients from our registry of 2453 patients who underwent a perfusion computed tomographic study and had their hemoglobin A1c (HbA1c) measured. These 26 patients were divided into 2 groups: those with HbA1c>6.5% (n=15) and those with HbA1c≤6.5% (n=11). Perfusion computed tomographic studies were processed using a delay-corrected, deconvolution-based software. Perfusion computed tomographic values were compared between the 2 patient groups, including mean transit time, which relates to the cerebral capillary architecture and length.
RESULTS
Mean transit time values in the nonischemic cerebral hemisphere were significantly longer in the patients with HbA1c>6.5% (P=0.033), especially in the white matter (P=0.005). Significant correlation (R=0.469; P=0.016) between mean transit time and HbA1c level was observed.
CONCLUSIONS
Our results from a small sample suggest that chronic hyperglycemia may be associated with cerebral microvascular remodeling in humans. Additional prospective studies with larger sample size are required to confirm this observation.
背景与目的
使用灌注 CT 研究探讨慢性高血糖对脑微血管重塑的影响。
方法
我们从 2453 例接受灌注 CT 研究且测定了糖化血红蛋白（HbA1c）的患者的登记册中回顾性地确定了 26 例患者。这 26 例患者分为两组：HbA1c>6.5%（n=15）和 HbA1c≤6.5%（n=11）。使用延迟校正、基于反卷积的软件处理灌注 CT 研究。比较两组患者之间的灌注 CT 值，包括与脑毛细血管结构和长度相关的平均通过时间。
结果
HbA1c>6.5%的患者非缺血性大脑半球的平均通过时间明显较长（P=0.033），尤其是在白质中（P=0.005）。观察到平均通过时间与 HbA1c 水平之间存在显著相关性（R=0.469；P=0.016）。
结论
我们的小样本结果表明，慢性高血糖可能与人类脑微血管重塑有关。需要更大样本量的前瞻性研究来证实这一观察结果。
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