腹型肥胖与脑梗死及其TOAST分型相关性研究

CORRELATION BETWEEN ABDOMINAL OBESITY,CEREBRAL INFARCTION AND TOAST GROUPING

目的研究腹型肥胖与脑梗死及其病因的关系。方法采用病例对照研究,选取脑梗死病人304例,正常对照282例,对两组的基线资料、体质量指数（BMI）和腹围进行比较。并比较脑梗死合并腹型肥胖254例与脑梗死非腹型肥胖50例的基线资料,以及两组按照TOAST分型各病因分型的构成比。结果脑梗死组和对照组年龄、性别构成差异无显著性,脑梗死组有糖尿病史、高血压史、高脂血症史者所占比例及收缩压、空腹血糖和低密度脂蛋白（LDL）均明显高于对照组（2χ=37.958~78.690,t=2.253~12.199,P〈0.05）,而总胆固醇、三酰甘油、高密度脂蛋白（HDL）和尿酸水平低于对照组（t=2.409~7.109,P〈0.05）。两组腹型肥胖所占的比例、BMI体质量超标和肥胖所占的比例、腹围及BMI比较,差异无显著性（P〉0.05）。脑梗死病人腹型肥胖组男性所占的比例低于非腹型肥胖组（χ2=5.531,P〈0.05）,有糖尿病史者、空腹血糖、三酰甘油、胆固醇、LDL及尿酸在腹型肥胖组明显多于或高于非腹型肥胖组（χ2=7.240,t=2.000~4.004,P〈0.05）,两组的血压和HDL差异无显著性（P〉0.05）。两组病人按照TOAST病因分型未发现各型之间有明显差异（P〉0.05）。结论腹型肥胖与脑梗死的发病及病因无明显关系,脑梗死合并腹型肥胖病人更多地存在代谢紊乱情况。

Objective To investigate the relationship between abdominal obesity（AO） and cerebral infarction（CI） and its etiological factors. Methods Using case-control study method,304 CI patients and 282 healthy individuals were enrolled,the base-line data,body mass index（BMI） and abdominal circumference（AC） between the two groups were compared.The base-line data and constituent ratio according to TOAST grouping between 254 AO CI patients and 50 non-AO CI patients were compared.Results The difference between CI patients and normal controls was not significant in terms of age and sex structure;the ratio of a history of diabetes,hypertension and hyperlipidemia,and systolic pressure,fasting blood sugar,and LDL were significantly higher in CI than that in the control group（χ2=37.958-78.690,t=2.253-12.199,P0.05）,whereas total cholesterol,triglycerides,HDL and uric acid levels were lower（t=2.409-7.109,P0.05）.The proportion of AO,overweight,obesity and AC between the two groups was not significantly different（P0.05）.In male CI patients,the proportion of AO was lower than NAO（χ2=5.531,P0.05）;a history of diabetes was more commonly seen,and levels of blood sugar,triglyceride,cholesterol and LDL and uric acid were higher in AO than NAO（χ2=7.240,t=2.000-4.004,P0.05）,but the difference of blood pressure and HDL was not significant between the two groups（P0.05）.According to TOAST grouping,no significant difference was found between AO and NAO groups. Conclusion The results suggest that abdominal obesity is not obviously associated with infarction of the brain.There is more metabolic disorder in patients with the infarction complicating abdominal obesity.