2型糖尿病并发脑梗死68例临床分析

目的 分析2型糖尿病与脑梗死的相关性,以进一步指导临床工作。方法 对我院2007年1月至2010年4月收治的2型糖尿病合并脑梗死患者(糖尿病组)68例与非糖尿病脑梗死患者(非糖尿病组)76例进行对比分析,比较2组患者的血压、年龄、血清甘油三酯、总胆固醇、低密度脂蛋白胆固醇、梗死部位、梗死数目,临床特征及预后。结果 糖尿病组患者腔隙性脑梗死及多发性脑梗死发生率分别为41.2％ (28/68)及33.8％ (23/68),较非糖尿病组15.8％ (12/76)及19.8％ (15/76)明显升高,差异有统计学意义(x2 =15.5,P＜0.01);糖尿病组收缩压(155.8±24.0) mm Hg、舒张压(89.6±15.0)mm Hg、血清甘油三酯(1.6±0.3) mmol/L、低密度脂蛋白胆固醇(1.3±0.7) mmol/L,与非糖尿病组收缩压(138.5±22.0)nn Hg、舒张压(84.7±14.0) mm Hg、血清甘油三酯(1.2±0.2) mmol/L、低密度脂蛋白胆固醇(2.7 ±0.3) mmol/L比较,差异均有统计学意义(t值分别为1.96、1.65、2.03、1.85,P＜0.05或＜0.01);糖尿病组患者年龄[(50.6±6.4)岁]较非糖尿病组[(57.8±6.5)岁]明显年轻(t=1.80,P＜0.01);2组住院时间比较糖尿病组住院时间长[(17.8±5.7)d与(14.5±6.3)d,t=1.67,P＜0.05]。结论 糖尿病是脑梗死和脑梗死恶化的危险因素,早期预防或治疗糖尿病,严格控制血糖水平,同时给予控制血压、血脂等综合治疗对预防或减少缺血性梗死的发生及预后有重要的临床意义。

The analysis for the clinical features of 68 patients with Type 2 diabetes mellituscomplicated with cerebral infarction

Objective To analyze the association between type 2 diabetics and cerebral infarction and to guide the future clinical practice.Methods A comparison study was conducted between 68 patients with Type 2 diabetes mellitus complicated with cerebral infarction(DCI) and 76 patients with cerebral infarction but no diabetic cerebral infarction (NDCI) .They were hospitalized during January 2007 and April 2010 and compared for the difference in blood pressure(BP), the cholesterol (TG), the triglyceride (TC), the lipoprotein cholesterol(LDC-C), the ages, the position of infarction, the amount of infarction, the clinical manifestations and the prognosis.Results The patients with DCI had more lacunar infarction(41.2％) and multiple infarctions (33.8％) than those with NDCI(15.8％ and 19.8％) .The difference was statistically significant (P ＜0.01) In the diabetic patients group, compared with the control group, the systolic blood pressure was ([155.8 ±24.0]mm Hg) vs.([138.5 ± 22.0]mm Hg), diastolic blood pressure was ([89.6 ± 15.0]mm Hg) vs.([84.7 ±14.0]mm Hg),the TG([1.6 ± 0.3]mmol/L vs.[1.2 ±0.2]mmol/L),the LDC-C(1.3 ±0.7]mmol/L vs.[2.7 ± 0.3]mmol/L) and the ages(50.6 ± 6.4) years vs.(57.8 ± 6.5) years.These parameters in DCI group patients were significantly higher than that of NDCI group(P ＜0.01) .The DCI patients had a longer hospitalization period ([17.8±5.7]and [14.5±6.3]d,t=1.67,P＜0.05].Conclusion Diabetes is a risk factor of cerebral infarction and of the deterioration of cerebral infarction.Prevention or treatment at a early stage of diabetes and strict control of blood sugar,the blood pressure as well as blood lipids is essential to reduce the occurrence of ischemic infarction and improve the prognosis.