The Clinical Study On The Relationship Between Red Blood Cell Distribution Width And Acute Cerebral Infarction With Type 2 Diabetes Mellitus

Objective :Several researches have pointed out that red blood cell distribution width(Red blood cell distribution width,RDW)is associated with the occurrence and development of cerebral infarction.However,there was rare research about the relationship between RDW and type 2 diabetes mellitus with cerebral infarction.The study is aim to compare the clinical data of patients with type 2 diabetes with acute cerebral infarction and type 2 diabetes without acute cerebral infarction,investigating the relationship between RDW and type 2 diabetes with acute cerebral infarction and risk factors for the development of cerebral infarction,providing new ideas for the diagnosis and treatment of type 2 diabetes mellitus with acute cerebral infarction.Methods:The study collected patients who hospitalized in the Department of Neurology,The First Affiliated Hospital of Wannan Medical College from October1,2019 to October 31,2020.All patients were divided into two groups according to whether they had acute cerebral infarction: group A and group B.Patients in group A were type 2 diabetes mellitus with acute cerebral infarction(n=127)and group B were type 2 diabetes(n=114).Patient’s neurological impairment was evaluated by NIHSS score in group A on the day of admission,and was divided into mild stroke,moderate stroke,and severe stroke.Group A was divided into group C(poor prognosis)and group D(good prognosis)according to the m RS score.To collect clinical data from all patients,including general data,laboratory indicators and imaging data.All data was statistically analyzed by SPSS23.0 software.The relationship between RDW and type 2diabetes mellitus with acute cerebral infarction and the related risk factors of acute cerebral infarction was investigated further.Results:Univariate analysis showed that there was significant difference between two groups in the history of hypertension,RDW,neutrophil to lymphocyte ratio,white blood cell,neutrophil,fasting blood glucose,low density lipoprotein,and glycated hemoglobin(P<0.05),and there was no significant difference in other indexes(P>0.05).Putting the positive valve of univariate analysis into the multivariate Logistic regression equation showed that RDW was an independent risk factor for type 2 diabetes with acute cerebral infarction(OR=-2.132,95%CI:0.040-0.354,P<0.001),low density lipoprotein was an independent risk factor for type 2 diabetes with acute cerebral infarction(OR=-2.132,95%CI:0.040-0.354,P=0.007<0.05),glycated hemoglobin was an independent risk factor(OR=-0.597,95%CI:0.343-0.884,P=0.013<0.05),and the prediction model was:Logit(P)=41.298+RDW×-2.132+LDL×-1.919+Hb A1C×-0.597.Comparison of the indexes of mild,moderate and severe neurological deficits in group A:severe group was higher than moderate group in the NLR and NE value,severe group were higher than mild group in the NLR,WBC and infarction volume value,moderate group were higher than mild group in the FBG and infarction volume value,and these difference was statistically significant(P<0.05).There was significant difference between group C and group D in age,infarction volume,NIHSS score,NE,NLR and RDW by univariate analysis(P<0.05),and there was no significant difference in other indexes(P>0.05).Putting the indexes with statistical significance of univariate analysis between the two groups into the multivariate Logistic regression equation showed that RDW was an independent risk factor for type 2 diabetes mellitus with acute cerebral infarction(OR= 1.750,95%CI:1.440-23.009,P=0.013<0.05),infarction volume was an independent risk factor for type 2 diabetes mellitus with acute cerebral infarction(OR=0.261,95%CI:1.009-1.670,P=0.042<0.05),NIHSS was an independent risk factor for type 2 diabetes mellitus with acute cerebral infarction(OR= 0.645,95%CI:1.445-2.516,P=0.001<0.05),and the prediction model was:Logit(P)=-27.419+RDW×1.75+ infarction volume×0.261+NIHSS score×0.645.Conclusions:This study found that RDW,NLR.,WBC,NE,FBG,LDL,Hb A1 C and the history of hypertension were the influencing factors of acute cerebral infarction in type2 diabetes mellitus.RDW,infarction volume and NIHSS score were independent risk factors for the prognosis of type 2 diabetes mellitus with acute cerebral infarction.Therefore,RDW has certain clinical value in predicting the occurrence and prognosis of type 2 diabetes with acute cerebral infarction.