脑梗死合并代谢综合征患者的临床特征分析

Clinical characteristics of patients with cerebral infarction complicated with metabolic syndrome

目的 分析脑梗死合并代谢综合征（MS）患者的临床特征及其与脑血管病变程度的相关性.方法 脑梗死患者685例按照2004年中华医学会糖尿病学分会关于MS的诊断标准分为MS组（n=340）和非MS组（n=345）.回顾性比较2组患者临床特征,分析MS与脑血管病变程度的相关性.结果 MS组的体重指数（BMI）、腰围、动脉血压、总胆固醇、三酰甘油（TG）、尿酸、空腹血糖（FBG）、餐后2 h血糖（2hPG）、糖化血红蛋白（HbA1c）均显著高于非MS组（P〈0.05或〈0.01）;而高密度脂蛋白胆固醇（HDL-C）水平显著低于非MS组（P〈0.01）;2组间低密度脂蛋白胆固醇（LDL-C）差异无统计学意义（P＞0.05）.MS组头颅CT显示大灶梗死和多灶梗死发生率和重型神经功能缺损发生率均显著高于非MS组（P〈0.01）.相关分析显示,脑血管病变程度与患者腰围、动脉血压、总胆固醇、TG、HbA1c、FBG及2hPG水平呈正相关（r=0.26、0.19、0.24、0.32、0.21、0.28、0.29,P〈0.05）,与HDL-C水平呈负相关（r=-0.23,P〈0.01）.结论 脑梗死合并MS患者动脉粥样硬化危险因子更加聚集,脑血管病变程度更加严重.

Objective To explore the clinical characteristics of patients with cerebral infarction （CI） complicated with matablic syndrome（MS） and their correlation with severity of eerebrovascular disease. Methods The clinical data of 685 cases with CI were retrospectively analyzed. The patients were catogorized into two groups （ MS group, n = 340 ; non -MS group, n = 345 ） using the diagnostic criteria （2004） of Chinese Medical Association Diabetes Branch. The clinical eharacheristics as well as the correlation between MS and severity of cerebral vascular lesions were analyzed Re- sults The MS group showed higher body mass index（BMI） , waist circumference, blood pressure, serum total cholester- ol（ TC ）, triglyceride （TG） , uric acid, fasting blood glucose （ FBG ） , 2 - hour postprandial blood glucose （ 2hPG ） , glu- eosylated hemoglobin Alc（ HbAlc）, and lower high - density fipoprotein - cholesterol（ HDL - C） than non - MS group. Larger size and multiple infarcts and more serious score of neurological deficit were shown in MS group. Severity of eere- brovascular disease disclosed by CT was positively correlated to levels of waist circumference, blood pressure, TC, TG, HbA1 c, FBG and 2 hPG （ r = 0.26, 0.19, 0.24, 0.32, 0.21, 0.28, 0.29, respectively, P 〈 0.05 ） , while negatively correlated to the levels of HDL - C （ r = - 0. 23,P 〈 0.01 ）. Conclusion Patients with CI complicated with MS are usually associated with multiple risk factors for athcrosclerosis and more severe cerebrovascular disease.