不同类型卒中与代谢综合征的相关性研究

目的探讨代谢综合征（metabolic syndrome,MetSyn）及其各单一组分危险因素对不同类型卒中的影响。方法选择发病后3周的首发或复发卒中患者,其中脑梗死患者576例（脑梗死组）,脑出血76例（脑出血组）,500例为同期的非脑血管病体检者（对照组）。分析各组MetSyn发生率以及MetSyn和单一组分危险因素与不同类型卒中的相关性。结果①脑梗死和脑出血组患者MetSyn的发生率分别为57.3%（330/576）、39.5%（30/76）,两组比较P〈0.01,均明显高于对照组的26.8%（134/500,P均〈0.01）,差异有统计学意义。②脑梗死组空腹血糖升高、三酰甘油（TG）增高、高密度脂蛋白胆固醇（HDL-C）降低的发生率分别为50.4%（290/576）、33.5%（193/576）、46.5%（268/576）,明显高于脑出血组的35.5%（27/76）、26.3%（26/76）、31.6%（24/76）,P均〈0.01;而脑出血组高血压病的发生率为88.2%（67/76）,显著高于脑梗死组的74.8%（431/576）,P〈0.01。③与脑梗死相关的危险因素依次为：高血压病（OR=3.56,P〈0.01）、MetSyn（OR=2.24,P〈0.01）、空腹血糖升高（OR=1.94,P〈0.01）、HDL-C降低（OR=1.72,P〈0.01）、TG增高（OR=1.44,P〈0.05）;与脑出血相关的危险因素为高血压病（OR=13.41,P〈0.01）。④伴糖尿病的MetSyn患者脑梗死的患病危险度（OR=13.39）是非糖尿病MetSyn患者的6.8倍（OR=1.98）。结论高血压病为缺血性、出血性卒中的共同危险因素;而MetSyn、糖尿病和脂代谢紊乱是脑梗死的独立危险因素,而不是脑出血的独立危险因素。

Correlation study of different types of stroke and metabolic syndrome

Objective To investigate the effects of metabolic syndrome （MetSyn） and its component risk factors on different types of stroke. Methods The patients with first or recurrent stroke 3 weeks after the onset of symptoms were selected. Among them, there were 576 patients with cerebral infarction （ CI group）, and 76 patients with cerebral hemorrhage （CH group） ; another 500 patients without cerebrovascular diseases as the control group. The incidence of MetSyn in all groups, and the correlation between its individual risk factors with different types of stroke were analyzed. Results ①The incidences of MetSyn in the CI and CH groups were 57.3% and 39. 5% , respectively. There was statistical significance between the 2 groups （ P = 0. 003 ）. and were significantly higher than that in the control group （ 26. 8% ） , P 〈 0. 01. ②The incidences of high fasting blood glucose and triglyceride （TG） , and low high-density lipoprorein cholesterol （HDL-C） in the CI group were 50. 4% , 33.5% and 46. 5% , respectively. They were significantly higher than those （35.5% , 26. 3% and 31.6% ） in the CH group （P 〈0. 01 ）. The incidence of hypertension in the CH group was 88. 2% , and it was significantly higher than that （74. 8% ） in the CIgroup （P =0. 000）. ③The risk factors associated with cerebrovascular infarction were in the order of hypertension （ OR = 3. 56 ,P 〈 O. 001 ）, MetSyn （ OR = 2. 24, P 〈 0. 001 ） , high fasting blood glucose（ OR = 1.94,P 〈0.001）, low HDL-C （OR=l.72,P〈O. O01）, and high TG （OR=1.44,P=O. O40） ; the risk factor related to cerebral hemorrhage was hypertension （ OR = 13.41, P 〈0. 001 ）. The risk of cerebral in- farction in patients with MetSyn accompanied with diabetes （OR = 13.39） was 6. 8 times higher than that in patients with MetSyn alone （ OR = 1.98 ）. Conclusions Hypertension is the common risk factor for ischemic and hemorrhagic strokes; and the MetSyn, diabetes and lipid disturbance are the independent risk f