2型糖尿病与急性缺血性脑梗死患者病情及预后关系研究

目的分析合并2型糖尿病的急性缺血性脑梗死患者入院时的病情及预后,探讨糖尿病对缺血性脑梗死的影响程度。方法回顾性分析合并2型糖尿病的缺血性脑梗死(CI+DM组)组100例患者的临床资料,并与无糖尿病的缺血性脑梗死(CI组)组50例患者进行对比分析。结果 CI+DM组三酰甘油(TG)为(2.03±1.18)mmol/L,高密度脂蛋白(HDL-C)为(1.08±0.29)mmol/L;CI组TG为(1.65±0.61)mmol/L、HDL-C为(1.18±0.29)mmol/L,两组比较,差异有统计学意义(P<0.05)。CI+DM组纤维蛋白原为(94.10±1.27)g/L,血小板聚集率为(50.68±18.23)%;CI组纤维蛋白原为(3.39±0.97)g/L,血小板聚集率为(32.82±22.57)%,两组比较,差异有统计学意义(P<0.01)。CI+DM组与CI组比较,同型半胱氨酸差异无统计学意义,入院及出院时NHISS评分无统计学差异,但治疗后两组NHISS评分较治疗前均减低,且CI+DM组NHISS评分高于CI组,提示CI+DM组患者预后差。CI+DM组以腔隙性脑梗死(LACI)比例最多,而CI组以部分前循环梗死(PICA)比例最多;颈动脉硬化程度两组比较,差异无统计学意义。结论与CI组相比,CI+DM组HDL-C降低、TC升高;纤维蛋白原升高,血小板聚集率升高;CI+DM组以腔隙性脑梗死居多,呈多灶病变,预后差,遗留神经功能缺损严重,本研究为重视和管理CI+DM患者血糖,促进神经功能恢复和改善预后提供临床依据。

The Study of Correlation Between Type 2 Diabetes and the Condition and Prognosis of Acute Ischemic Stroke Patients

Objective To analyse the condition and prognosis of acute ischemic stroke patients with type 2 diabetes,and investigate the impact of type 2 diabetes on acute ischemic stroke.Methods 100 cases with acute ischemic cerebral infarction and type 2 diabetes mellitus(CI+DM),50 cases with acute ischemic cerebral infarction but had no diabetes(CI),their clinical data were collected and analyzed.Results CI+DM group triglycerides value(TG)was(2.03±1.18)mmol/L,and high-density lipoprotein(HDL-C)was(1.08±0.29) mmol/L;CI group TG was(1.65±0.61)mmol/L,HDL-C was(1.18±0.29)mmol/L,two groups compared,the difference was statistically significant(P<0.05).CI+DM group fibrinogen value was(4.10±1.27)g/L,and platelet aggregation rate was(50.68±18.23)%,CI group fibrinogen value was(3.39±0.97)g/L,platelet aggregation rate was(32.82±22.57)%,two groups compared,the difference was statistically significant(P<0.01).Compared CI+DM group with CI group,there was no significant difference in homocysteine and uric acid with diabetes mellitus(DM) or not(NDM).On admission and the discharge from hospital,NHISS score was no significant difference between two groups,and after treatment NHISS score was reduced.But CI+DM group NHISS score was higher than CI group,which suggested that the poor prognosis in CI+DM group.And lacunar infarction(LACI) was the majority proportion in CI+DM group;partial anterior circulation infarction(PICA) was the majority proportion in CI group.The degree of carotid atherosclerosis had no statistical difference between two groups.Conclusion Compared with CI group,HDL-C was reduce in CI+DM group,and it was increased in TC,fibrinogen,platelet aggregation rate;and the ratio of carotid atherosclerosis and plaque.In CI+DM group,it seemed to be mostly showed lacunar infarction and multifocal lesions,and poor prognosis,serious neurological deficit.For the attention and management blood sugar of CI+DM group,for promoting nerve functionrestore and improve the prognosis,this study provided the clinical evidence.