短暂性脑缺血发作合并代谢综合征对脑卒中的影响

The impact of transient ischemic attack combined with metabolic syndrome on stroke

目的研究短暂性脑缺血发作(transient ischemic attack,TIA)合并代谢综合征(metabolic syndrome,MS)对脑卒中的影响。方法选择老年TIA患者275例,根据是否合并MS分为TIA合并MS组(MS组)146例和TIA未合并MS组(非MS组)129例,根据ABCD^2评分将患者分为低危、中危、高危,对2组临床资料进行回顾性对比分析。结果 MS组高血压、糖尿病、吸烟、过量饮酒、体重指数、空腹血糖、TG、TC、LDL-C、纤维蛋白原明显高于非MS组,而HDL-C明显低于非MS组,差异有统计学意义(P<0.01);MS组ABCD^2评分,低危16例(11.0%),中危94例(64.4%),高危36例(24.7%),非MS组低危40例(31.0%),中危69例(53.5%),高危20例(15.5%),MS组低危患者较非MS组低危患者明显减少,差异有统计学意义(P<0.01);MS组中危和高危患者较非MS组中危和高危患者明显增多,差异有统计学意义(P<0.05)。MS组7、30及90 d脑卒中发生率分别为13.7%、15.8%、22.6%,非MS组7、30及90 d脑卒中发生率分别为6.2%、7.8%、8.5%。MS组7、30及90 d脑卒中发生率明显高于非MS组,差异有统计学意义(P<0.05,P<0.01)。结论 TIA合并MS患者ABCD^2评分为中危和高危明显多于TIA未合并MS患者,且低危、中危、高危脑卒中发生率明显增多。

Objective To study the impact of transient ischemic attack（TIA） combined with meta- bolic syndrome（MS） on stroke. Methods Clinical data of 275 elderly patients with TIA were re- viewed. They were divided into MS group（n= 146） and non-MS group（n= 129）. Results The hy- pertention,diabtes, smoking status, alcohol consumption, BMI, FPG, TG, TC, LDL-C, fibrinogen in MS group were significantly higher than those in non-MS group（P〈0.01）. ABCD2 score in MS group showed that the low-risk cases were 16 （11.0%）, the intermediate-risk cases were 94 （64.4%） and the high-risk cases were 36（24.7%）,comparatively in non-MS group,the low-risk cases were 40（31.0 %）, the intermediate-risk cases were 69 （53.5 % ） and the high risk cases were 20（15.5%）. In MS group,the low-risk rate was lower（P〈0.01） ,the intermediate-risk and high- risk rates were significantly higher（P〈0.05）. The stroke incidences on 7 d,30 d and 90 d of hos- pitalization were 13.7%,15.8% and 22.6% in MS group,compared with 6.20% ,7.8% and 8.5% in non-MS group,there were significant differences between the two groups（P〈0.05 ,P〈0.01 ）. Conclusion In patients with TIA combined with MS,the ABCD2 scores of intermediate-risk and high-risk were higher than in patients with TIA but without MS, and the stroke incidence in- creased significantly.