2型糖尿病并发脑梗死的危险因素研究

Exploration of risk factors and control measures for type 2 diabetes complicated with cerebral infarction

目的分析2型糖尿病并发脑梗死的相关危险因素,为脑梗死的临床防治提供指导。方法选取本院2007年6月~2012年11月收治的516例2型糖尿病患者,根据是否并发脑梗死进行分组,其中研究组98患者并发脑梗死,而对照组418例未并发脑梗死。分析两组患者的临床资料,并通过单因素相关分析筛选出与脑梗死发生相关的因素,再进行多因素Logistic回归分析。结果 2型糖尿病患者发生脑梗死的独立危险因素为吸烟(OR=2.13,95%CI:1.36~5.85)、暴饮暴食(OR=1.93,95%CI:1.19~3.20)、高血压病史(OR=2.65,95%CI:1.02~4.36)、冠心病史(OR=2.07,95%CI:1.48~5.57)、用药不规则(OR=1.27,95%CI:1.13~4.48)、血糖控制欠佳(OR=3.21,95%CI:1.65~3.91)、TG≥2.6mmol/L(OR=2.88,95%CI:1.13~4.63)、LDL-C≥3.36mmol/L(OR=1.81,95%CI:1.13~3.15)、HDL-C≤0.91mmol/L(OR=2.32,95%CI:1.65~4.75)。结论对于2型糖尿病患者,平时节制饮食,戒除烟酒,按时服用降血压、降血脂药物,并控制血糖,可降低并发脑梗死的危险度。

Objective To analyze the risk factors of type 2 diabetes complicated with cerebral infarction and provide practical guidance for the clinical prevention and treatment of cerebral infarction.Methods 516 patients with type 2 diabetes admitted to our hospital from June 2007 to November 2012 were divided into two groups according to whether there was cerebral infarction or not.The study group consisting of 98 patients was complicated with cerebral infarction; the control group consisting of 418 patients was not complicated with cerebral infarction.The clinical information of the two groups of patients was analyzed.The single factor correlation analysis was used to screen out the factors significantly related to the occurrence of cerebral infarction,and then the multivariate Logistic regression analysis was conducted.Results The independent risk factors for patients with type 2 diabetes to have cerebral infarction were smoking (OR=2.13,95% CI:1.36-5.85),overeating (OR=1.93,95% CI:1.19-3.20),history of hypertension (OR=2.65,95% CI:1.02-4.36),history of coronary artery disease(OR=2.07,95%CI:1.48-5.57),irregular medication(OR=1.27,95%CI:1.13- 4.88),poor blood glucose control (OR=3.21,95%CI:1.65-3.91),TG≥2.6 mmol/L (OR=2.88,95%CI:1.13-4.63),LDL- C≥3.36 mmol/L (OR=1.81,95%CI:1.13-3.15) and HDL-C≤0.91 mmol/L (OR=2.32,95%CI:1.65-4.75).Conclusion For patients with type 2 diabetes,dietary restraint,smoking cessation,regular administration of hypotensive and hypolipidemic drugs and blood glucose control can reduce the risk of concurrent cerebral infarction.