高血压和糖尿病患者颅内脑动脉狭窄的观察

目的 了解高血压和糖尿病引起脑血管狭窄的危险程度。方法 选择激光医科大学附属第一医院（南方组）和北京协和医院（北方组）TCD室在特定时间内检查的所有患者。TCD检查颅内脑动脉狭窄,同时记录患者的年龄、性别、高血压和糖尿病情况。计数资料间比较使用x^2检验;高危因素危险比的合并使用固定效应模型;脑动脉狭窄的危险因素分析使用Logistic多元回归。结果 南方和北方50岁患者高血压（HT）、糖尿病（DM）、同时患HT和DM（MIX）及不患这2种疾病（Nor)组,大脑中动脉狭窄的频率分别是：南方6．96％、11．43％、20．59％和1．75％;北方6．24％、11．18％、13．51％和1．95％;HT、DM和MIX的危险比分别为：南方4．0％、6．5、11．8;北方3．2、5．7、6．9;南北方合并后危险比为2．9、16．9和37．3。在以上4组中,南北方大脑中动脉狭窄频率差异无显著意义。南方患者大脑中动脉狭窄与年龄、特别、HT和DM的Logistic回归分析显示,HT和DM是脑动脉狭窄的独立危险因素;男女人群分别计算,男性组只有糖尿病、女性组只有高血压引入回归方程。结论 HT和DM是引起颅内脑动脉狭窄的独立高危因素。DM危险性较HT严重,患2种疾病时危险性进一步提高,这些引起脑动脉狭窄的危险性可能存在性别差异。

Intracranial artery occlusive diseases in patients with hypertension and diabetes mellitus

OBJECTIVES: To investigate risk effects of hypertension (HT) and diabetes mellitus (DM) to intracranial artery occlusive lesions. METHODS: 845 patients (South group) visiting the First Affiliated Hospital of Zhejiang University, and 2325 patients (North group) visiting the Peking Union Medical College Hospital were assessed respeitively. All the patients underwent transcranial Doppler detection to discover intracranial occlusive artery lesions. Age, sex, hypertension (HT) and diabetes mellitus (DM) were included in the analysis. RESULTS: Among the patients > or = 50 years old, the frequencies of middle cerebral artery(MCA) occlusive diseases were: 6.96%, 11.43%, 20.59% and 1.75% in South; 6.24%, 11.18%, 13.51% and 1.95% in North, when suffering from HT, DM, both of HT and DM(MIX), or neither of them(Nor). The risk ratios of HT, DM, MIX were: 4.0, 6.5 and 11.8 in South; 3.2, 5.7 and 6.9 in North; and 2.9, 16.9 and 37.3 when combining South and North. There were no statistical differences of frequencies of MCA occlusive lesions under HT, DM and MIX between the South and North. Multi-variable logistic regression analysis showed that HT and DM were significant and independent predictors for MCA occlusive lesion. The details of other cerebral arteries were canceled here. CONCLUSIONS: Hypertension and diabetes mellitus may contribute to the development of occlusive lesions of the cerebral arteries in Chinese people.