缺血性脑血管病合并2型糖尿病患者全脑血管造影特点分析

Analysis of Pancerebral Angiography of Ischemic Cerebrovascular Disease with Type Ⅱ Diabetes

目的探讨缺血性脑血管病合并2型糖尿病患者全脑血管造影的特点。方法应用荷兰飞利浦公司生产的FD-20 C型臂血管造影系统,对247例缺血性脑血管病合并2型糖尿病(糖尿病组)患者与372例缺血性脑血管病不合并2型糖尿病(对照组)患者的全脑血管造影结果进行比较。结果糖尿病组与对照组血管狭窄程度差异有统计学意义(χ2=31.57,P<0.05);糖尿病组中,中重度狭窄和闭塞的患者明显多于对照组(χ2=30.34,P<0.05)。两组均以多支血管病变为主,但糖尿病组多支血管病变的发生率明显高于对照组(72.05%vs53.56%),且以弥漫性血管病变(64.63%)和无侧支血管代偿(71.18%)为主,而对照组以非弥漫性血管病变和无侧支血管代偿为主。在糖尿病组中,随着糖化血红蛋白的增加,中重度狭窄和闭塞、多支病变及弥漫性病变发生率逐渐明显增加,有侧支代偿的比例逐渐减少,各组间均有统计学意义。结论缺血性脑血管病合并2型糖尿病患者全脑血管狭窄程度更重,常表现为多支血管病变、弥漫性血管病变并且侧支代偿少,血糖控制不佳加重上述损害。

Objective To investigate the characteristics of pancerebral angiography of ischemic cerebrovascular disease with type Ⅱdiabetes. Methods Compare the results of the paneerebral angiography of 247 cases of ischemic cere brovascular disease with type Ⅱdiabetes （the diabetes group） and 372 cases of ischemic eerebrovascular disease without typeⅡdiabetes（ the control group）. Results The difference of vascular stenosis of the two groups has statistical signif- icance（x2 = 31.57 ,P 〈 0.05 ）. There are more Cases of moderate -severe vascular stenosis and occlusion in the diabetes group than the control group（x2 = 30.34 ,P 〈 0.05）. The majority of vascular involvement are intraeranial blood vessels 2 in the two groups. The middle cerebral arteries are the most easily involved. But the difference is not slgmficant （X = 0.02, P 〈 0.05 ）. （Multiple blood vessels are involved for the majority of the two groups. But the incidence rate is higher in the diabetes group than the control group（72.05% vs 53.56% ）. The majority of vascular involvement in the diabetes group were diffuse without collateral circulation（64.63% and 71.18% ）. The majority of vascular involvement in the con trol group are not diffuse without collateral circulation. In the diabetes group, with the increase of glycosylated hemoglobin, the incidence of moderate severe vascular stenosis and occlusion, multivessel lesions and diffuse lesions significantly in creased gradually, gradually reduce the percentage of collateral circulation gradually reduced, each group has statistical sig nificance. Conclusions The characteristics of paneerebral angiography of ischemie cerebrovascular disease with type Ⅱ diabetes ： vascular stenosis is more severe and the majority of vascular involvement are intracranial arteries with multiple, dif fuse and little eomnensatorvmanfestations, poor blood sugar control aggravate the lesions.