脑梗死合并糖尿病相关危险因素临床探讨

目的探讨脑梗死合并糖尿病的临床特点及相关危险因素。方法将我院2005年1月至2010年1月收治的148例脑梗死患者,按是否合并糖尿病分为两组,合并糖尿病组(n=70)和非糖尿病组(n=78),分析比较两组病例的临床表现、影像学检查及血糖等对病情预后的关系。结果合并糖尿病组高血压、高血脂、偏瘫等的发生率明显高于非糖尿病组(P<0.01),在意识障碍、感觉障碍、失语等方面两组比较差异无统计学意义(P>0.05)。CT检查显示合并糖尿病组多灶性、腔隙性脑梗死的发生率明显高于非糖尿病组,两组比较差异有统计学意义(P<0.05或<0.01)。合并糖尿病组患者随着血糖的增高治愈率越低,病死率越高。结论脑梗死合并糖尿病以多灶性、腔隙性梗死为主,多伴有高血糖、高血压、血脂代谢紊乱等危险因素,其疗效及病情预后较不合并糖尿病患者差,在治疗中应尽早控制血糖,使空腹血糖控制在6～8mmol/L,餐后2h血糖控制在10mmol/L以下。另外控制高血压、降低血黏度、纠正高脂血症等治疗对脑梗死的治疗和预防均有重要意义。

Clinical investigation of relative risk factors of cerebral infarction with diabetes Mellitus

Objective To investigate the clinical features and relative risk factors of cerebral infarction with diabetes mellitus.Methods 148 cases of patients in our hospital from January,2005 to January,2010 with cerebral infarction were divided into two groups:the group with diabetes(n=70) and the group without diabetes(n=78).Clinical manifestation,imaging study and the relationship of blood glucose to prognosis of the disease were analyzed comparatively for these two groups.Results Rates of hypertension,hyperlipidemia,hemiplegia of the group with diabetes were significantly higher than those of the group without diabetes(P<0.01).In terms of consciousness disturbance,sensory disturbance,aphasia,etc.There was no significantly statistical difference(P>0.05).CT examination showed that the multifocal rate,the occurrence of lacunar infarction for the group with diabetes were higher than those of the group without diabetes(P<0.05 or <0.01).The cure rate of patents in the group with diabetes was lowered when the blood sugar increased and the fatality rate got higher.Conclusion Cerebral infarction with diabetes mellitus are mainly multifocal and lacunar infarction,usually accompanied by risk factors such as hyperglycemia,hypertension,and lipid metabolic disorder.The curative efficacy and prognosis of such diseases are worse than those of cerebral infarction without diabetes.It is important to control the blood glucose,which shouldbe 6～8 mmol/L before meals and lower than 10 mmol/L after meals.In addition,it is significant to control hypertension,to reduce blood viscosity,to correct hyperlipidemia for preventing and treating cerebral infarction.