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1.
目的研究代谢综合征在脑卒中患者中的患病状况。方法研究对象为390例初发脑卒中患者,对照组为400例年龄、性别匹配者,研究总结代谢综合征及其危险因素的患病率,经Logistic回归分析其对脑卒中的危险性。结果代谢综合征的现患率在脑卒中组高于对照组。代谢综合征的现患率在脑卒中病例组为28.3%,对照组为9.8%,差异有显著意义。腔隙性脑梗死、脑梗死和脑出血的代谢综合征现患率分别为26.0%、29.5%和27.3%。Logistic回归分析显示代谢综合征是脑卒中的独立危险因素。结论代谢综合征在脑卒中患者中患病率较正常人群高,是脑卒中的独立危险因素。  相似文献   

2.
目的 探讨高同型半胱氨酸血症或伴高血压的高同型半胱氨酸血症人群与脑卒中发生的关系.方法 采用高压液相色谱技术(HPLC)检测266例脑卒中患者(204例脑梗死,62例脑出血)和140非卒中患者血同型半胱氨酸(Hcy)水平.结果 脑卒中组Hcy平均值和高Hcy血症检出率明显高于对照组(P〈0.05);脑卒中组Hcy水平中度以上升高比例明显高于对照组(P〈0.05),脑卒中组高Hcy伴高血压比例相对单纯高血压或单纯高Hcy成倍数增加.结论 高同型半胱氨酸或伴高血压的同型半胱氨酸血症是脑卒中的重要风险因子之一,伴高血压的同型半胱氨酸血症患脑卒中的风险更大.  相似文献   

3.
目的探讨脂蛋白(a)(Lp(a))是否为缺血性卒中的危险因素,以及Lp(a)水平与缺血性脑卒中类型和预后的关系。方法将缺血性脑卒中患者按急性卒中治疗低分子肝素试验.TOAST)分型标准分为心源性脑栓塞(CE)、大动脉粥样硬化性卒中(LAA)、小动脉卒中(SAA)、其他原因引发的缺血性卒中(SOE)和原因不明的缺血性卒中(SUE)。以同期入院的非脑卒中患者(经头颅CT或磁共振排除)作为对照组。病例组和对照组均于入院次日清晨空腹抽取静脉血,测定Lp(a)及其他各项血脂指标,并于入院及病程两周时分别行NHISS评分评估神经功能缺损程度,分析Lp(a)与卒中类型及NIHSS评分之间的关系。结果缺血性脑卒中组Lp(a)浓度及异常率均高于对照组(P〈0.05),Lp(a)进入大动脉粥样硬化卒中患病因素的回归方程Lp(a)水平与卒中患者的NIHSS评分无相关性(P〉0.05)。结论高浓度Lp(a)可能参与了缺血性脑卒中的发生,并且可能是大动脉粥样硬化性卒中发生的危险因素,但与神经功能缺失程度和早期功能修复无关。  相似文献   

4.
目的探讨急性缺血性卒中患者颅内动脉粥样硬化性狭窄与不同血糖水平代谢综合征的相关性。方法选取2013年6月-2016年6月入住本院神经内科的急性缺血性卒中患者352例为研究对象,根据颅内血管狭窄情况分为狭窄组227例和非狭窄组125例;选取同期非颅内动脉粥样硬化性狭窄体检者310例为对照组。研究对象中合并代谢综合征的患者分为3个亚组:糖耐量正常组、伴糖尿病组、伴高血糖组(包括空腹血糖受损、糖耐量降低)。同时测定代谢综合征患者血脂水平,分析不同血糖水平代谢综合征与颅内动脉粥样硬化性狭窄的相关性。结果 352例急性缺血性卒中患者共确诊代谢综合征195例(55.39%),其中狭窄组和非狭窄组代谢综合征的发生率均明显高于对照组,比较差异有显著性(P0.05);狭窄组代谢综合征的发生率明显高于非狭窄组,比较差异有显著性(P0.05)。狭窄组中伴糖尿病的代谢综合征患者比例明显高于非狭窄组和对照组,比较差异有显著性(P0.05);狭窄组中伴高血糖和糖耐量正常的代谢综合征患者比例与非狭窄组比较,差异均无显著性(P0.05)。Logistic回归分析显示:代谢综合征与颅内动脉粥样硬化性狭窄存在明显相关性;代谢综合征伴糖尿病、伴低高密度脂蛋白(high density lipoprotein,HDL)、高甘油三酯(triglyceride,TG)与颅内动脉粥样硬化性狭窄发生风险呈明显正相关。结论在急性缺血性卒中患者中,代谢综合征尤其是糖尿病、高TG血症及低HDL血症和颅内动脉粥样硬化性狭窄密切相关。  相似文献   

5.
目的探讨急性脑卒中合并代谢综合征患者的临床预后。方法选择急性脑卒中患者382例,根据国际糖尿病联盟的代谢综合征诊断标准分为代谢综合征组和非代谢综合征组,其中代谢综合征组170例,非代谢综合征组212例,两组均给予相同的治疗和健康教育。比较两组患者治疗前、治疗后神经功能缺损评分(NIHSS),分析急性脑卒中合并代谢综合征患者的临床预后。结果代谢综合征组患者在体重、腰围、收缩压、甘油三脂等均高于非代谢综合征组;两组患者的NIHSS在治疗前无统计学差异(P=0.129),治疗后差别具有统计学显著性(P=0.013)。结论急性脑卒中合并代谢综合征患者的临床预后较差。  相似文献   

6.
目的研究血脂异常与缺血性脑卒中及其各亚型的关系。方法收集516例缺血性脑卒中患者及131例非缺血性卒中对照组个体的血脂情况,包括血总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)等指标,对其进行统计分析比较。并将其中131例缺血性脑卒中患者根据TOAST分型标准进行分型,将各亚组的血脂水平与对照组再进行比较。结果缺血性脑卒中组的HDL水平明显低于对照组,TC/HDL比值明显高于较对照组。其余血脂成分,包括TC、TG、LDL则未发现存在显著差异。亚组比较中,大动脉粥样硬化性卒中(LAA)组、心源性脑栓塞(CE)组、小动脉闭塞性卒中或腔隙性卒中(SAO)组的HDL水平明显低干对照组,而他们的TC/HDL比值则明显高于对照。其余血脂成分比较未见统计学差异。其他原因卒中(SOE)及不明原因卒中(SUE)均显示与血脂各成分无相关性。结论HDL在缺血性脑卒中患者明显降低,其保护因素降低可能是卒中发生的原因之一。TC/HDL比值可作为衡量血脂异常与缺血性卒中关系的指标之一。需要进一步进行基于卒中分型基础上的更大样本量的研究。  相似文献   

7.
脑卒中后抑郁对预后的影响   总被引:4,自引:0,他引:4  
脑卒中后抑郁(PSD)是脑卒中后情感障碍中最常见的一种。近年来我们对部分PSD患者进行临床观察研究,发现由于抑郁,患者悲观失望,对疾病的恢复丧失信心,不积极主动配合治疗,最终延缓神经功能的恢复,影响疾病的预后,降低患者的生活质量。现将有关资料分析探讨如下。1对象与方法1.1研究对象我院自1997年10月至1998年12月间住院的脑卒中病人,伴抑郁者45人,其中出血性卒中26例,缺血性卒中19例;男29例,女16例;平均61岁。另随机抽取同期住院的不伴抑郁者(即对照组)39人,其中出血性卒中20例…  相似文献   

8.
脑卒中患者血管紧张素转换酶基因多态性分析   总被引:5,自引:0,他引:5  
目的:研究血管紧张素转换酶(ACE)基因多态性和脑卒中的发病关系。方法:应用PCR方法检测105例脑卒中患者、106例原发性高血压(EHT)患者及64例正常人的 ACE基因的缺失/插人(D/I)多态性。结果:脑卒中组ACE基因型及等位基因频率与EHT组及正常对照组比较差异无显著意义,脑卒中组中脑梗死组和脑出血组分别与正常对照组比较ACE基因型均无显著差异。脑卒中伴EHT组与无伴EHT组比较,Ⅱ基因型频率明显升高,而DD基因型频率则明显降低;脑卒中伴 EHT组Ⅱ基因型频率明显高于 EHT组,而 DD基因型频率远低于 EHT组和正常对照组,同时脑卒中伴EHT组的平均年龄较其它组明显高。结论:原发性高血压患者中Ⅱ基因型携带者可能具有卒中易感性,DD基因型携带者有随年龄增加而减少的趋势。  相似文献   

9.
脑微出血与脑卒中   总被引:8,自引:1,他引:7  
目的探讨脑微出血与脑卒中发生、发展的联系。方法卒中患者83例,分为脑缺血组(43例)和脑出血组(40例),以同期住院的50岁以上非脑卒中患者设立对照组(32例)。采用T2加权梯度回波MRI观察各病例脑微出血、卒中病灶、腔隙性梗塞以及白质疏松情况,同时记录卒中患者的高血压、糖尿病、高脂血症、卒中病史以及阿司匹林使用史。结果微出血在缺血组和出血组的发生率分别为34.9%、75.0%,对照组9.4%。各组微出血均最常见于基底节区。微出血与高血压、卒中病史相关(P〈0.01),与高脂血症、糖尿病病史及使用阿司匹林无关(P〉0.05)。微出血的严重程度与腔隙性梗塞、白质疏松的严重程度相关(P〈0.01)..微出血在卒中病灶区域同侧或对侧分布无显著性差异(P〉0.05)。出血组微出血在卒中病灶区域的分布率明显高于缺血组。结论微出血与脑卒中.特别是与出血性脑卒中有密切关系,对卒中患者出血性转化具有预测意义。  相似文献   

10.
目的 探讨脑卒中后抑郁患者前额叶氢质子磁共振波谱(1H-MRS)的特点.方法 以31例卒中后抑郁患者为研究组,以30例脑卒中患者为病例对照组,以30例健康志愿者为正常对照组.3组在入组24 h内采用多体素1H-MRS检测双侧前额叶各生化代谢物的变化并进行数据处理.结果 研究组左右侧前额叶NAA/Cr值均低于病例对照组和正常对照组,差异均有统计学意义(均P<0.05);研究组左侧前额叶Cho/Cr值显著高于正常对照组,差异具有统计学意义(P<0.05);研究组双侧前额叶NAA/Cr值与HAMD评分呈显著性负相关(均P<0.05),而双侧前额叶Cho/Cr值与HAMD评分不存在相关关系(P>0.05).结论 前额叶神经元代谢的异常可能是卒中后抑郁的神经生物学基础.  相似文献   

11.
Limited information is available on the relationship between metabolic syndrome and stroke in the Chinese population. The aim of this study was to establish the prevalence of metabolic syndrome in the Chinese population and the relationship between stroke and metabolic syndrome in that population. 2,173 subjects aged 45 years and above without a history of stroke were recruited from six communities in Chongqing city, China. The participants were followed for incident stroke events (ischemic stroke and hemorrhagic stroke) for 5 years. Incidence rates and hazard ratios (HRs) for both subtypes of stroke were stratified by the presence or absence of metabolic syndrome and by each component. Among the subjects, women had a higher prevalence rate of metabolic syndrome than men (26 vs. 19%). As the number of metabolic syndrome components increased, HRs increased significantly, up to 5.1 (95% CI, 1.9–7.4) for ischemic stroke and 3.3 (95% CI, 1.7–5.7) for hemorrhagic stroke. We found that abdominal obesity had the highest HR (2.12, P < 0.001) for ischemic stroke, followed by metabolic syndrome (HR 1.65, P < 0.001). For hemorrhagic stroke, high blood pressure had the highest HR (2.17, P < 0.001), followed by abdominal obesity (HR 1.83, P < 0.001). After 5-year follow-up, the survival rates of stroke events were 94.2% among those with metabolic syndrome and 96.9% among those without. As the number of metabolic syndrome components increased, survival rates decreased progressively, from 99.6% for individuals with none of the components to 90.1% for those with four to five components. The results showed that metabolic syndrome is highly prevalent among the Chinese adult population and is associated with an increased risk for both ischemic stroke and hemorrhagic stroke.  相似文献   

12.
ObjectiveMultiple sclerosis (MS) is related to the demyelination of intracranial nerves at multiple sites, while restless legs syndrome (RLS) appears to be caused by dysfunction of the dopaminergic system. Since RLS prevalence is higher among MS patients than in the general population, we carried out an updated meta-analysis to understand whether the two diseases might be associated.MethodWeb of Science, PubMed, Embase, Chinese National Knowledge Infrastructure, Wanfang, and SinoMed databases were searched for observational and case-controlled studies of RLS prevalence in MS. Eligible studies were meta-analyzed using Stata 12.0.ResultsPooled RLS prevalence among MS patients of various ethnicities was 26%, and prevalence was lower in Asia (20%) than outside Asia (27%). Prevalence was higher among cross-sectional studies (30%) than among case–control studies (23%). RLS prevalence was higher among female than male MS patients (26% vs. 17%), and it was higher among MS patients than among healthy controls (OR 3.96, 95%CI 3.29–4.77, p < 0.001).ConclusionOur meta-analysis updates the most recent meta-analysis in 2013 and provides perhaps the first reliable pooled estimate of RLS prevalence in MS. The available evidence strongly suggests that RLS risk is higher among MS patients than healthy controls.  相似文献   

13.
People with metabolic syndrome (MS) are at increased risk of coronary heart disease and other health problems, such as diabetes and stroke. However, there is little previous information on the prevalence and determinants of MS among people with intellectual disabilities (IDs). The present study aimed to examine the prevalence of MS risk factors among institutionalized adults with IDs. We analyzed the annual health check data of 164 institutionalized adults with IDs whose age was ≧20 years in 2009. The measure of MS in the study was the presence of three or more of the following five components: central obesity, elevated blood pressure (BP), elevated fasting glucose (FG), elevated triglycerides (TG), and reduced high-density lipoprotein (HDL-C). The prevalence of MS was 11.6% in the study participants (8% in males and 17.2% in females), which is lower than that in the general population of Taiwan. In the logistic regression analysis of the occurrence of MS, we found that gender, TG and HDL-C were variables that could significantly predict MS after controlling for other potential factors. Adults with IDs who were female (OR = 38.354, 95% CI = 1.985-741.029) and who had higher TG levels (OR = 1.043, 95% CI = 1.008-1.079) and reduced HDL-C levels (OR = 0.696, 95% CI = 0.549-0.883) had a statistically higher risk of MS. This study was one of the first to provide information on the prevalence of MS and its risk factors among institutionalized adults with IDs. We suggest that further study should focus on the specifics of MS, such as incidence, age-specific risk factors and further prevention or treatment in people with ID.  相似文献   

14.
目的 探讨急性缺血性脑血管病(AICD)患者颈动脉粥样硬化(CA)的特点以及代谢综合征(MS)对CA的影响.方法 应用彩色多普勒超声仪检查514例AICD患者及300例对照组的颈动脉,比较两组颈动脉内中膜厚度(IMT)、斑块指数、CA发生率及MS患病率.按是否有CA将AICD患者分成CA组及非CA组,分析两组MS的患病率以及MS和其单一组分危险因素与CA的相关性.结果 (1)AICD组MS患病率、IMT、斑块指数及CA发生率均明显高于对照组,比较差异有统计学意义(P<0.05).(2)CA组MS、高血压、三酰甘油(TG)增高、低密度脂蛋白胆固醇(LDL-C)增高及总胆同醇(TC)增高的发生率高于非CA组,比较差异有统计学意义(P<0.05).(3)调整年龄、性别、吸烟史和其他单一组分危险因素后,MS依然增加CA患病的危险,其OR值为2.43.95%CI为1.81~3.96.(4)伴糖尿病的MS患者CA的患病危险度(OR值为22.46)是不伴糖尿病的MS患者的5.6倍(OR值为3.98).结论 AICD患者MS及CA患病率高,MS是CA的独立危险因素,并和其各单一组分危险因素及糖尿病相互作用促进CA的发生.  相似文献   

15.
BACKGROUND: Idiopathic neuropathy patients are at high risk of impaired glucose tolerance (IGT). Hyperglycemia, low high density lipoprotein (HDL), elevated triglycerides (TRG), hypertension and central obesity co-associate and constitute the metabolic syndrome. Patients with hyperglycemia are at high risk of having the syndrome and each of its features. Our null hypothesis was that patients with neuropathy and IGT would have a higher prevalence of other metabolic syndrome features than those without hyperglycemia. The primary objective was to determine if metabolic syndrome features other than hyperglycemia increase neuropathy risk. METHODS: The prevalence of metabolic syndrome features was determined among 219 sequential patients with idiopathic peripheral neuropathy. Subjects were classified as having IGT or normoglycemia. The prevalence of metabolic syndrome was compared to published population prevalence data. To compensate for potential referral bias, data were also compared for175 diabetic subjects without neuropathy, given the well-recognized risk of metabolic syndrome among diabetic individuals. RESULTS: Contrary to our hypothesis, neuropathy patients with normoglycemia and IGT shared a similarly elevated prevalence of metabolic syndrome features compared to published normal populations. Compared to diabetic subjects without neuropathy, the normoglycemic neuropathy patients had significantly higher total and LDL cholesterol, and a higher prevalence of abnormal HDL and triglycerides. The prevalence of obesity and hypertension was similar among patient groups. Normoglycemic neuropathy subjects had significantly more features of metabolic syndrome (other than hyperglycemia) than diabetics. CONCLUSIONS: These findings demonstrate an association between neuropathy and metabolic syndrome features other than hyperglycemia. Lipid abnormalities are particularly prevalent among neuropathy subjects.  相似文献   

16.
精神分裂症合并代谢综合征的调查   总被引:1,自引:0,他引:1  
目的调查精神分裂症合并代谢综合征(metabolic syndrome,MS)的患病率及相关因素。方法对住院的210例精神分裂症患者进行MS调查和相关实验室指标测定,MS的诊断标准采用2004年中华医学会糖尿病分会标准。结果资料完整的精神分裂症住院患者210例;精神分裂症患者合并MS的患病率为18.9%,72.1%的患者至少有1项MS成分;MS组饮酒史阳性者比例显著高于非MS组(P〈0.05);体重指数(BMI)与MS的发生直线相关(r=0.350,P〈0.01)。结论精神分裂症患者具有较高的MS发生风险,BMI是一项重要的预测指标,饮酒史是危险因素。  相似文献   

17.
目的旨在初步研究伴有代谢综合征(metabolic syndrome,MS)的首发缺血性卒中(first-ever ischemicstroke,FIS)患者在入院时基线水平的性别差异。方法对2008年8月~2009年11月在北京天坛医院神经内科住院的连续入组的FIS患者进行横断面调查。依据国际糖尿病联盟(the International Diabetes Federation,IDF)2005年对MS的定义对入选患者进行分组,对比男性、女性患者之间的差异。结果 602例FIS患者中,男411例(占68.5%)、女191例(占31.7%),伴MS患者共234例,其中男11 7例,占男性FIS患者的28.5%;女117例,占女性FIS患者的61.5%。男性伴MS患者吸烟、饮酒发生率明显高于伴Ms的女性(74.5% vs 14.5%,P0.001;66.7% vs 4.5%,P0.001)。中心性肥胖、低高密度脂蛋白、高血压发生率在女性明显高于男性(79.1% vs 34.8%,P0.001;62.8% vs 38.9%,P0.001;97.4%vs 89.1%,P=0.024)。女性伴MS的患者同女性不伴MS的患者比较,患大动脉粥样硬化性(largeartery atherosclerosis,LAA)缺血性卒中的风险更高(67.4%vs 48.4%,P=0.011)。男性伴MS的患者同男性不伴MS的患者比较,在此卒中亚型上未见显著差异(29.2%vs 25.3%,P=0.490)。结论在FIS患者中,女性患者MS的发生率远高于男性患者。在伴有MS的FIS患者当中,和女性相比,男性更常见的危险因素为吸烟、饮酒;而和男性相比,女性更常见的危险因素为中心性肥胖及低高密度脂蛋白、高血压。伴MS的女性FIS患者,更易感LAA性缺血性卒中,而在伴MS的男性患者中未见到明显卒中亚型的差别。  相似文献   

18.
Most studies point to an increased prevalence of metabolic syndrome (MS) and an increased risk of coronary heart disease (CHD) in schizophrenia patients with MS. The aims of this study were to compare the prevalence of MS in schizophrenia patients with the general population, to explore the clinical correlates and predictors of MS and to evaluate the risk for CHD within 10 years. Consecutive 319 patients, aged 18–75 years, with a diagnosis of schizophrenia according to the DSM-IV were enrolled. The ATP-III, the ATP-IIIA and the IDF criteria were used to define MS. 10-year risk of CHD events was calculated with the Framingham score. One hundred nine (34.2%) patients met the ATP-III criteria, 118 (37%) the ATP-IIIA and 133 (41.7%) the IDF criteria for MS. Patients with MS were older, had a later onset of illness and an older age at first hospitalization. The prevalence of MS in schizophrenia patients was higher from the general population only within the 20–29 age group. Patients with MS had a higher age and sex-corrected 10-year risk of CHD events. The only predictor of MS was the age of illness onset. In conclusion, countries where the general population prevalence of MS is already too high, schizophrenia patients younger than 30 years of age might be under higher risk of morbidity and mortality related with MS. This study points to the necessity for aggressive interventions to correct MS in schizophrenia as early as possible, within the first 10 years of post detection.  相似文献   

19.

Background

The risk factors for intracranial atherosclerosis are unclear but may differ from those for other stroke subtypes. Here, we investigated whether metabolic syndrome, an emerging risk factor for cardiovascular disease, is associated with intracranial atherosclerotic stroke.

Methods

Using the Adults Treatment Panel III criteria, we evaluated the components of metabolic syndrome in 439 patients with ischemic stroke or transient ischemic attacks. The prevalence of metabolic syndrome within each stroke subtype was determined, and the association between intracranial atherosclerosis and metabolic syndrome was evaluated.

Results

Metabolic syndrome was observed more frequently in patients with intracranial atherosclerosis than in those with other types of stroke (P=0.003). In a multiple regression analysis, metabolic syndrome, but not conventional risk factors, was independently associated with intracranial atherosclerosis (P=0.016). By contrast, the serum level of C-reactive protein was correlated negatively with the presence of intracranial atherosclerosis. Intracranial atherosclerosis was most prevalent in patients with metabolic syndrome and low levels of C-reactive protein (P=0.024).

Conclusions

Our results indicate that metabolic syndrome is a strong independent risk factor for intracranial atherosclerotic stroke. Therefore, treatment of metabolic abnormalities may be an important prevention strategy for intracranial atherosclerotic stroke.  相似文献   

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