2型糖尿病伴发腔隙性脑梗死相关因素分析

Risk factors of type-2 diabetes combined with lacunar cerebral infarction

目的探讨2型糖尿病伴发腔隙性脑梗死的相关危险因素。方法选择驻马店市中心医院综合内科收治的210例2型糖尿病患者为研究对象，将其分为A组：2型糖尿病未伴发腔隙性脑梗死组（119例），B组：2型糖尿病伴发单发性腔隙性脑梗死组（67例），C组：2型糖尿病伴发多发性腔隙性脑梗死组（24例1。收集各组患者性别、年龄、既往史、实验室检查指标等各项临床资料，通过单因素分析及多因素分析行统计学比较。结果B组、C组患有高血压病史比例明显高于A组，差异有统计学意义俨〈0．05）。C组患者重度颈动脉狭窄率明显高于A组、B组，而B组患者重度颈动脉狭窄率明显高于A组，差异均有统计学意义（P〈0．05）。C组患者三酰甘油（TG）、血清总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）与A组、B组比较差异有统计学意义俨〈0．05）；B组患者TG与A组比较差异有统计学意义fP〈0．05）。B组、C组患者糖化血红蛋白（HbArc）、C-反应蛋白（CRP）、尿微量白蛋白（MA）、颈动脉内膜中层厚度（CIMT）与A组比较差异有统计学意义（P〈0．05）。高血压史、重度颈动脉狭窄率、TG、HbArc、CRP、MA、CIMT为2型糖尿病伴发单发性腔隙性脑梗死的独立危险因素，而高血压史、重度颈动脉狭窄率、TC、HDL．C、TG、LDL—C、HbArc、CRP、MA、CIMT为2型糖尿病伴发多发性腔隙性脑梗死的独立危险因素。结论影响2型糖尿病伴发单发性腔隙性脑梗死和伴发多发性腔隙性脑梗死的危险因素各有不同，临床上应加以区分对待。

Objective To investigate the risk factors of type 2 diabetes combined with lacunar cerebral infarction. Methods Two hundred and ten patients with type 2 diabetes were selected in our study and divided into 3 groups： group A, type 2 diabetes without combined with lacunar cerebral infarction （n=119）; group B, type 2 diabetes combined with single lacunar cerebral infarction （n=67） and group C, type 2 diabetes combined with multiple lacunar cerebral infarction （n=24）. The gender, age, disease history and laboratory examination were collected and analyzed with univafiate analysis and multivariate analysia. Results Patients of group B and C had a significantly higher ratio of having hypertension history than patients of group A （P〈0.05）. Rate of severe carotid artery stenosis in patients of group C was significantly higher than that of group A and B （P〈0.05）; and that of group B was significantly higher than that of group A （P〈0.05）. The levels of triacylglycerol （TG）, serum total cholesterol （TC）, high density lipoprotein cholesterol （HDL-C） and low density lipoprotein cholesterol （LDL-C） in group C showed statistically significant differences with those in group A and B （P〈0.05）; the TG level in group B had statistically significant difference with that in group A （P〈0.05）. Levels of HbAlc, C reactive protein （CRP） and microalbuminuria （MA）, and carotid intima-media thickness （clMT） in group B and C were statistically different as compared with those in group A （P〈0.05）. Hypertension history, severe carotid artery stenosis, levels of TG, HbAlc, CRP and MA, and CIMT were the independent risk factors of type 2 diabetes combined with single lacunar cerebral infarction; while levels of TC,HDL-C, LDL-C, TG, HbAlc, CRP and MA, and CIMT were the independent risk factors of type 2 diabetes combined with multiple lacunar cerebral infarction. Conclusion The risk factors affect the type 2 diabetes combined with single lacunar cerebral infarction and type 2 diabetes combined with multiple lacunar cerebral infarction are different, which needs to make a difference in clinic.