糖尿病患者脑卒中危险因素的病例对照研究

目的　研究糖尿病患者脑卒中的危险因素 ,为糖尿病脑卒中的防治提供依据。方法　在对首都钢铁公司 2 9859名职工进行糖尿病患病率调查的基础上 ,采用 1∶1配对病例对照研究设计 ,对所检出的糖尿病 92 3例进行脑卒中危险因素调查。主要危险因素包括血压、血糖、胆固醇、甘油三酯、糖化血红蛋白及高密度脂蛋白等。结果　糖尿病组脑卒中 59例 (6 .39% ) ,对照组 1 7例 (1 .84% ) ,优势比值为 3 .6(95 %置信区间 :2 .1 1～ 6 .2 9,P <0 .0 1 )。其中糖尿病组脑梗死 51例 ,占 5 .53 % ,是对照组 (1 .1 9% )的 4 .6倍 ;糖尿病组脑出血 5例 ,占 0 .54 % ,与对照组 (0 .43 % )比较差异无显著性意义。糖尿病组高血压、冠心病的患病率及糖化血红蛋白、甘油三酯及血糖明显高于对照组 (P <0 .0 1 )。Logistic多元回归分析结果表明 ,糖尿病患者脑梗死的其他危险因素中 ,冠心病优势比值最高为 6 .1 2 ,其次为高肌酐血症、高糖化血红蛋白、高血压和高甘油三酯。结论　糖尿病是脑梗死的重要危险因素。冠心病、高肌酐血症、高糖化血红蛋白、高血压和高甘油三酯增加糖尿病患者发生脑梗死的危险

Risk factors for stroke in diabetes patients

Objective To study risk factors for stroke in diabetes patients. Methods 29?859 workers aged from 20 to 71 years old in the Capital Steel Iron Company were studied. It was a population based case control study. Diabetes mellitus (DM) cases (n=923) were matched for age and sex with control subjects. The type of stroke was confirmed by CT examination. Data of medical history were collected from cases and control subjects by interviewing with the subject. Results The prevalence of stroke was 6.39% in diabetic group and 1.84% in the control group, with odds ratio of 3.6(95%CI was 2.11～6.29); the prevalence of ischemic stroke was 5.53%, which was 4.6 times that of control group(1.19%). There were only 4 cases of hemorrhage in diabetic group, with no difference between the two groups. Coronary heart disease, high serum creatinine (SCr) and glycosylated hemoglobrn (HbA 1c ) were important risk factors of ischemic stroke in diabetic patients. Conclusion Diabetic subjects are more at risk of ischemic stroke. Coronary heart disease, higher SCr and HbA 1c were important risk factors of ischemic stroke.