2型糖尿病合并脑梗死56例临床分析

目的探讨2型糖尿患者合并脑梗死的特点。方法113例脑梗死患者分为治疗组56例，为糖尿病合并脑梗死患者，对照组57例为非糖尿病的脑梗死患者，两组患者入院后均采用综合治疗措施，控制血压、扩血管、降低颅内压、抗血小板聚集，改善循环，营养神经及对症治疗。同时治疗组通过饮食控制，口服降糖药或胰岛素治疗，将空腹血糖控制在6—8mmol／L，餐后2h血糖控制在10mmol／L以下。两组患者均测定血压（BP）、空腹血糖（FBG）、餐后血糖（PBG）、糖化血红蛋白（HbA1c）、血清总胆固醇（TCH）、三酰甘油（TG）、高密度脂蛋白（HDL）及低密度脂蛋白（LDL）对比并分析其与病情、预后的关系。结果2型糖尿病合并脑梗死患者组的脑神经损伤程度高于与非糖尿病脑梗死患者组（P〈0．05）。2型糖尿病合并脑梗死患者组血压、血糖水平、餐后血糖、糖化血红蛋白、血脂均高于非糖尿病脑梗死患者组（P〈0．05）。2型糖尿病合并脑梗死患者组的治疗效果低于非糖尿病脑梗死患者组，病死率高于非糖尿病脑梗死患者（P〈0．05）。结论糖尿病合并脑梗死致残率高，糖尿病为急性脑血管病重要的独立危险因素，严格控制血糖、控制血压和纠正血脂是预防糖尿病合并脑梗死的重要手段。

Clinical Analysis on 56 Elderly Patients with Type 2 Diabetes Mellitus with Brain Infarction

Objective To investigate the clinical manifestation of patients with cerebral infarction complicated with type 2 diabetes mellitusMethods 56 patients with cerebral infarction complicated with diabetes were experimental group, and 57 patients with cerebral in control group didn＇t have diabetes. The clinical manifestation, treatment and the prognosis in experimental group were compared with those in control group in prospective study. Results The experimental group suffered from heavier injure of brain than those with cerebral infarction （ P 〈 0. 05 ）. The experimental group had significantly higher levels of f blood pressure, blood glucose levels, postprandial blood glucose, glyeosylated hemoglobin, lipids （ P 〈 0.05 ）, and a significantly lower level of the treatment. The control group had lower mortality （P 〈0. 05 ）. Conclusion This study suggests the experience group have higher disability, diabetes became an independent risk factors of acute eerebrovascular disease. The control of blood glucose and blood pressure and decrease of blood lipid are important way to prevent diabetes mellitus combined with cerebral infarction.