2型糖尿病患者并发脑卒中的危险因素

Risk factor of complicated stroke in patients with type 2 diabetes mellitus

目的:研究2型糖尿病并发脑卒中的危险因素,探讨其发病机制。方法:将96例2型糖尿病患者分为两组:伴有脑卒中的2型糖尿病患者50例(患者组)和不伴有脑卒中的2型糖尿病患者46例(对照组),测定两组患者的空腹血糖、糖化血红蛋白、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白A、载脂蛋白B以及体质量、血压,行Logistic多元逐步回归,筛选脑卒中的危险因素。结果:患者组糖尿病病程(OR,2.16;95%CI,1.31～4.23)、舒张压(OR,1.85;95%CI,1.25～3.89)、糖化血红蛋白(OR,3.94;95%CI,2.89～4.56)、总胆固醇(OR,1.72;95%CI,1.09～3.49)是脑卒中的独立危险因素,载脂蛋白A(OR,0.33;95%CI,0.25～0.89)是脑卒中的保护因素。结论:控制血糖、血压、血脂,可以有效降低脑卒中的发生率,改善糖尿病患者的生活质量。

AIM:To study the risk factors of complicated stroke in patients with type 2 di abetes mellitus(DM) and to investigate the pathogenesis. METHODS:Ninety-six patients with type 2 DM were assigned into type 2 DM patie nts complicated by stroke(n=50,case group) and those without complication(n=46,c ontrol group).Fasting blood glucose,glycosylated hemoglobin(HbA1c),triglycerides ,total cholesterol(TC),high density lipoprotein-cholesterol,low density lipopro tein-cholesterol,apolipoprotein A (Apo A),apolipoprotein B,body weight and bloo d pressure were measured. Logistic multiple stepwise regression was employed to evaluate the risk factors for stroke. RESULTS:In the case group,disease course of DM(OR,2.16;95%CI,1.31-4.23),d iastolic pressure(OR,1.85;95%CI,1.25-3.89), HbA1c(OR,3.94;95%CI,2.89-4 .56),and TC(OR,1.72;95%CI,1.09-3.49) were independent risk factors for stro ke,and Apo A(OR,0.33;95%CI,0.25-0.89) was a protective factor stroke. CONCLUSION:Decrease in incidence rate of stroke and improvement in quality of life for patients with DM are associated with the control of blood glucose,blood pressure and blood lipid.