2型糖尿病与非糖尿病颈内动脉系统急性脑梗死患者的临床比较

The clinical comparison between acute cerebral infarction in carotid artery system with type 2 diabetes and with non diabetes-mellitus

目的比较伴有2型糖尿病与非糖尿病的颈内动脉系统急性脑梗死患者血压、血脂,病损程度及颈动脉粥样硬化斑块分布情况和发生率的差异。方法筛选符合条件的2012年3月至2013年9月在潍坊市人民医院神经内科住院的150例颈动脉系统的急性脑梗死患者进入本研究,其中合并2型糖尿病的急性脑梗死患者90例,不合并2型糖尿病的急性脑梗死患者60例。收集两组患者常见脑血管病的危险因素,入院后的血压、血脂水平及美国国立卫生研究院脑卒中量表(NIHSS)评分以及颈动脉斑块分布情况和发生率,并对其进行统计分析和比较。结果两组患者常见脑血管病的危险因素差异无统计学意义;两组患者颈动脉斑块均以颈动脉分叉处最多,且均以不稳定斑块为主;急性脑梗死合并2型糖尿病患者斑块发生率高(χ2=7.234,P=0.007);两组患者的收缩压、甘油三酯、高密度脂蛋白胆固醇、NIHSS评分比较,差异均有统计学意义(t=2.815,P=0.006;t=6.686,P=0.000;t=-2.441,P=0.016;T=4000.00,P=0.039)。结论合并2型糖尿病的急性脑梗死患者斑块阳性率高,以不稳定斑块为主,多分布在颈动脉分叉处,且多合并血压及血脂异常。

Objective To compare the difference of blood pressure, lipids, lesion extent, and distribution and incidence of atherosclerotic plaque between acute cerebral infarction in carotid artery system with type 2 diabetes and that with non diabetes-raellitus. Methods The qualified 150 cases of acute cerebral infarction of carotid artery system in the study were included,90 cases of acute cerebral infarction with type 2 diabetes and 60 cases of acute cerebral infarction with non diabetes-mellitus. These patients were hospitalized in department of Neurology in Weifang People＇s Hospital affiliated to Weifang Medical College from March 2012 to September 2013. Common risk factors for cerebral infarction, blood pressure, lipids, National Institute of Health stroke scale ratings （NIHSS ratings）, lesion extent, and distribution and incidence of atherosclerotic plaque were collected. And statistical analysis and statistical comparisons were done. Results There was no significant difference in the incidence of common risk factors for cerebral infarction between the 2 groups. Carotid artery plaques were mostly distributed in carotid bifurcation（BIF） between the 2 groups,and most of them are vulnerable plaques. The acute cerebral infarction patients with type 2 diabetes had a higher incidence of carotid atherosclerosis plaque（x2 =7. 234 ,P =0. 007）. There is significant difference in systolic blood pressure （ SBP ）, triglycerides （ TC ）, high-density lipoprotein cholesterol （ HDL-C ）, NIHSS ratings between the 2 groups （ Statistics and P value ： SBP t = 2. 815, P = 0. 006 ; TC t = 6. 686, P = 0. 000 ; HDL t = - 2. 441,P = 0. 016 ; NIHSS ratings T = 4000. 00, P = 0. 039 ）. Conclusion The acute cerebral infarction patients with type 2 diabetes have a higher incidence of carotid atherosclerosis plaque, especially vulnerable plaque, mostly distributed in BIF. Most of them are abnormal in blood pressure and blood lipids.