2型糖尿病患者伴发脑梗死危险因素的研究

目的 探讨2型糖尿病伴发脑梗死的危险因素。方法 对32例2型糖尿病伴发脑梗死患者（A组）及30例单纯2型糖尿病患者（B组）分别询问生活习惯、病史，检测血脂、血糖、体质量、身高，超声检测颈总动脉内-中膜厚度（CCA—IMT）、斑块的发生率等，并进行相关性分析。结果 A、B两组间患者在年龄、吸烟史、糖尿病病程、以及高密度脂蛋病白、空腹血糖水平比较差异有显著性（均P〈0．05）；体质量指数、血总胆固醇、纤维蛋白原、糖化血红蛋水平的比较差异具有极显著性（均P〈0.01）；CCA—IMT及斑块发生率的比较差异也具有显著性（P〈0．05～0．01）；CCA—IMT与年龄、糖尿病病程、血纤维蛋白原、空腹血糖、糖化血红蛋白水平明显正相关（r分别为0．58、0.37、0．45、0.39、0．48，均P〈0．01），与血高密度脂蛋白水平呈负相关（r=-0．41，P〈0．05）。结论 观察空腹血糖、糖化血红蛋白、高密度脂蛋白、纤维蛋白原，监测CCA—IMT及斑块情况，适时干预，对2型糖尿病患者预防脑梗死并发症是有价值的。

Study of risk factors of type 2 diabetes mellitus patients complicated with cerebral infarction

Objective To study the risk factors of type 2 diabetes mellitus patients complicated with cerebral infarction.Methods 32 type 2 diabetes mellitus patients complicated with cerebral infarction(group A) and 30 type 2 diabetes mellitus patients (group B) were enrolled in the study. The living habit, history, blood lipids, blood glucose, body mass index and height were investigated, also common carotid artery intimal thickness (CCA-IMT) and plaque incidence rate were measured by two-dimensional color Doppler ultrasound, and the relationship between them was evaluated.Results There were significant differences between two groups in age, duration of smoking, course of diabetes, high density lipoprotein (HDL) and fasting blood glucose (FBG) (all P<0.05), also significant differences in body mass index, total cholesterol, fibrinogen (Fg) and glycosylated hemoglobin (HbA1c) (all P<0.01). CCA-IMT and plaque incidence rate were obviously different between the two groups ( P< 0.05~0.01). Positive correlations were found between CCA-IMT and age, duration of diabetes, HDL, Fg, FBG and HbA1c ( r= 0.58, 0.37, 0.45, 0.39 and 0.48, respectively, all P< 0.01). A negative correlation was found between CCA-IMT and HDL ( r=-0.41, P<0.05).Conclusion To prevent cerebral infarction in type 2 diabetes mellitus patients, it is valuable to control FBG, HbA1c, HDL, Fg and monitor CCA-IMT and plaque.