老年2型糖尿病患者血纤维蛋白原、血脂与缺血性脑卒中的关系

Association of plasma fibrinogen and lipids levels with ischemic stroke in elderly type 2 diabetic patients

目的 探讨老年2型糖尿病患者血纤维蛋白原（fibrinogen,FIB）、血脂与缺血性脑卒中的关系.方法 对152例老年2型糖尿病患者的临床及实验室资料进行了回顾性调查,根据是否并发缺血性脑卒中,分为并发缺血性脑卒中组和无脑卒中组,分析比较两组患者的合并高血压率、FIB、FPG、2hPG、HbAlc、TG、TC、LDL-C、HDL-C、非高密度脂蛋白胆固醇（non HDL-C）等指标.结果 并发缺血性脑卒中组患者的年龄、合并高血压率及FIB、TG、TC、non HDL-C等均明显高于无脑卒中组（均P＜0.05）.Logistic多因素回归分析结果表明,年龄、高FIB、高TG水平是老年2型糖尿病合并缺血性脑卒中的独立危险因素.结论 积极控制血糖、血压的同时早期积极的抗凝降纤、降脂等综合治疗,对预防和延缓老年2型糖尿病患者缺血性脑卒中的发生、发展具有十分重要的临床意义.

Objective To investigate the correlation of plasma fibrinogen （FIB） and lipids levels with ischemic stroke in el- derly type 2 diabetic patients. Methods Total152 elderly type 2 diabetic patients, including 42 ischemic stroke cases and 110 no stroke cases were included in the study. The clinical and laboratory data, including hypertension rate, blood fibrinogen （FIB）, fasting plasma glucose（FPG）, postprandial 2h plasma glucose（2hPG）, HbAIc, triglyceride（TG）, total cholesterol（TC）, low-density lipoprotein cholesterol （LDL-C）, high density lipoprotein cholesterol （HDL-C）, non-high-density lipoprotein cholesterol（non HDL-C） and other indicators were retrospectively analyzed and compared between two groups. Results The age, hypertension rate, FIB, TG, TC, and non HDL-C of ischemic stroke group were significantly higher than those of no stroke group （P〈0.05）. Lo- gistic regression analysis showed that the age, high fibrinogen, high triglyceride levels were independent risk factors for ischemic stroke in elderly type 2 diabetic patients. Conclusion The results indicate that early active treatments of anticoagulant, antifibrinolytic, comprehensive lipid-lowering, active control of blood glucose, blood pressure are of great clinical significance to prevent and delay the incidence and development of ischemic stroke in elderly type 2 diabetic patients.