三种诊断标准对脑梗死患者代谢综合征检出率的比较

目的观察和分析采用国际糖尿病联盟（IDF）、美国国家胆固醇教育计划成人治疗组第3次报告（ATPⅢ）及中国人代谢综合征（MS）标准（2007）诊断的MS在脑梗死患者中的检出率,为探讨适合中国人脑梗死预防的MS诊断标准提供依据。方法收集2006年7月—2008年8月住院和门诊经CT或MRI证实脑梗死患者756例,对照组为同期门诊体检者271例;回顾性地分析不同标准诊断的MS在脑梗死组和对照组中的检出率以及MS与脑梗死危险度的关系。结果根据IDF、ATPⅢ和中国人MS的标准诊断MS,在脑梗死组中的检出率分别是49.5%、36.5%和45.0%,3个标准诊断的MS在脑梗死组中的检出率均显著高于对照组的35.1%、18.8%和22.5%（均P〈0.01）,IDF和中国人MS标准诊断的MS的检出率显著高于ATPⅢ（P〈0.01）;IDF和ATPⅢ标准诊断的MS检出率在脑梗死组中女性高于男性,差异有统计学意义（P〈0.01）;中国人MS标准诊断的MS检出率在脑梗死组中,性别差异无统计学意义（P〉0.05）;中国人MS标准诊断的MS与脑梗死相关性最强（OR=2.562,95%CI为1.845～3.558,P〈0.01）。结论IDF和中国人的MS诊断标准更适合于国人脑梗死的预防;中国人MS诊断标准诊断的MS对国人脑梗死具有更高的预警作用。

Detectable rates of metabolic syndrome diagnosed by different criteria for cerebral infarction

Objectives To observe and analyze the relationship between metabolic syndrome （MS） diagnosed by the International Diabetes Federation （IDF）, the National Cholesterol Education Program （NCEP） Adult Treatment Panel Ⅲ （ ATP Ⅲ ）, and the Chinese diagnostic criteria for MS with cerebral infarction, and to explore the suitable diagnostic criteria of MS for Chinese to prevent cerebral infarction. Methods A total of 756 inpatients and outpatients with cerebral infarction confirmed by CT and MRI were recruited, and 271 healthy subjects over the same time period as the controls. The detection of MS diag- nosed by the 3 criteria, in cerebral infarction and control groups, as well as Ihe effect of MS on the risk of cerebral infarction were analyzed retrospectively. Results According to the MS diagnosed by the 1DF, ATP Ⅲ and the Chinese diagnostie criteria fnr MS, the detectable of MS in the cerebral infarction group were 49.5% , 36.5% , and 45.0% , respectively, there were significantly higher than 35.1% , 18.8% , and 22.5% in the control group （ all P 〈0.01 ）. The detectable rates of MS diagnosed by IDF and the Chinese diagnostic criteria were significantly higher than tirol by ATP Ⅲ criteria （ P 〈 0.01 ）. The detectable rates of MS diagnosed by IDF and ATP Ⅲ in the cerebral infarction group were 63.2% and 53.4% in remales, and 40.1% and 24.9% in males, respectively. There was significant difference between the two genders （P 〈 0.01 ）. The detectable rates of MS diagnosed by the Chinese diagnostic criteria in the cerebral infarction group were 48.5% in females and 42.5% in males. There was no significant difference between the two genders （ P 〉 0.05 ）. The specificity of the Chinese diagnostic criteria for MS was higher than IDF （77.5% vs. 64.4% ） , and it had the strongest correlation with cerebral infarction （ OR =2. 562, P 〈 0. 01 ）. Conclusions The IDF and the Chinese diagnostic criteria for MS are more suitable for Chinese to prevent cerebral infarction. MS diagnosed by the Chinese criteria has stronger early-warning effect for cerebral infarction in Chinese.