急性脑梗死合并2型糖尿病患者TOAST分型与尿酸、LDL-C的关系

The association between uric acid,LDL-C and TOAST Subtypes of Ischemic Stroke with type 2 diabetes

目的探讨急性脑梗死合并2型糖尿病患者的TOAST分型与血尿酸（SUA）、低密度脂蛋白胆固醇（LDL-C）的相关性。方法选择收入我院神经内科发病72 h且合并2型糖尿病的急性脑梗死患者426例,并进行TOAST分型,抽取空腹静脉血检测血SUA、LDL-C值,并分析其与TOAST分型的相关性。结果 TOAST分型中,大动脉粥样硬化性卒中（LAA）所占比例最高（48.6%）,小动脉卒中或腔隙性卒中（SAO）居第2位（31%）,其次分别为心源性卒中（CE）（9.9%）、其他原因所致缺血性卒中（SOE）（5.6%）、不明原因的缺血性卒中（SUE）（4.9%）;比较5种亚型SUA水平：LAA高于其他4类亚型（P〈0.01）,其余亚型两两比较无差异（P〉0.05）;LDL-C水平比较：LAA高于其他4种亚型（P〈0.05）,SAO高于CE（P〈0.05）,其余两两比较无差异;SUA（OR=1.26,95%CI 1.31~2.17）、LDL-C（OR=1.42,95%CI 1.32~1.96）是LAA的独立危险因素（P〈0.01）。结论急性脑梗死合并2型糖尿病患者中以LAA型最为多见,检测SUA、LDL-C值对进行病因分型具有重要临床意义。

Objective To analyze the The association between uric acid、LDL-C and TOAST Subtypes of Ischemic Stroke with type 2 diabetes. Methods To collect 426 patients of acute cerebral infarction with type 2 diabetes as the sample of observation. TOAST classification into the subcategories was determined via predefined specific clinical and imaging criteria. All of them being detected uric acid and LDL-C level by extracting of fasting venous blood. To analyze correlation between serum uric acid,low-density lipoprotein and TOAST Subtypes. Results 5 major categories of the TOAST classification are were as follows： large-artery atherosclerosis（ LAA）; small-artery occlusion（ SAO）; cardioembolism（ CE）; stroke of other determined cause（ SOE）; and stroke of undetermined cause（ SUE）. The LAA has had the highest proportion（ 48. 6%）,the SAO ranked second（ 31%）,followed by which is CE（ 9. 9%）; the rest of them are were respectively 5. 6%and 4. 9%. The SUA level of LAA is was higher than the other four subtypes（ P 0. 01）,and the rest of them have had no difference（ P 0. 05）. The LDL-C level of LAA is was higher than the other four subtypes（ P 0. 01）. SAO higher than CE（ P 0. 05）,the rest of other subtypes have had no difference（ P 0. 05）; SUA,and LDL-Care were independent risk factors for the LAA. Conclusion LAA is the most common type in acute cerebral infarction patients with type 2 diabetes,and testing SUA（ OR = 1. 26,95% CI 1. 31 ~ 2. 17）,LDL-C（ OR = 1. 42,95% CI 1. 32 ~ 1. 96） values have important clinical significance to TOAST classification.