糖尿病合并脑梗死患者影像学分布特点

Imaging distribution characteristics of cerebral infarction with diabetes mellitus

目的探讨糖尿病合并脑梗死患者病灶分布模式。方法 ⑴本院神经内科住院的606例急性脑梗死患者，根据头颅磁共振结果将其分成前循环皮质、放射冠、基底节和后循环梗死，并记录其性别、年龄、生化指标及有无高血压、糖尿病和心房颤动病史；⑵比较有无合并糖尿病时各亚型脑梗死的分布差异和不同亚型脑梗死组间糖尿病阳性率的差异，分析亚型脑梗死与糖尿病间的相关性，进一步回归分析相关亚型的危险因素。结果 ⑴合并糖尿病组与无合并糖尿病组的前循环皮质、放射冠、基底节和后循环梗死构成比差异有统计学意义（χ^2＝19.795，P＝0.000），糖尿病组的后循环梗死所占比率明显高于无糖尿病组（χ^2＝18.71，P〈0.01）；不同部位的脑梗死亚组间，其糖尿病的阳性率差异有统计学意义，其中后循环梗死最高[47%（76/163）]。⑵相关性分析显示，后循环梗死与糖尿病具有明显相关性（r＝0.176，P＝0.000）。⑶单因素Logistic回归分析显示，糖尿病与后循环梗死的发生密切相关，其OR值和95% CI分别为2.247和1.551-3.257，经相关因素校正后，其OR值和95% CI为1.898和1.213-2.968，两者P值均〈0.05。结论 合并存在糖尿病的脑梗死易于发生在后循环，糖尿病为后循环梗死的独立危险因素。

Objective To investigate the distribution of infarction in the population of cerebral infarction with diabetes mellitus and its influence factors. Methods （1） A total of 606 hospitalization patients of acute cerebral infarction was divided into cortical infarction, centrum ovale infarction, basal ganglion infarction and posterior infarction according to brain magnetic resonance imaging （MRI）. The sex, age, biochemical marker and coexist with hypertension, diabetes mellitus or not were recorded. （2） The distribution difference of subtype infarction between with and without diabetes was compared, so did the positive rate of diabetes among different subtype infarction. The correlation between subtype infarction and diabetes was analyzed, and the level-risk relationship of subtype infarction was performed through logistic regression. Results （1） There existed obvious difference in the constituent ratio of cortical infarction, centrum ovale infarction, basal ganglion infarction and posterior infarction between with and without diabetes （χ^2 = 19. 795, P = 0. 000 ）, percent of posterior infarction in diabetes group was higher than that in non-diabetes group （χ^2 = 18.71, P 〈 0. 01 ）. Among the infarction subtypes, positive rate of diabetes was obvious different, highest percent was existed in posterior infarction group [47 % （76/163）]. （2） Posterior infarction was correlated with diabetes, with the value of r and P was 0. 176 and 0. 000. （3） Logistic regression between posterior infarction and diabetes demonstrated that OR （95 % CI ） was 2. 247 （1. 551 -3. 257 ）, it changed to 1. 898 （ 1. 213 - 2. 968 ） when adjusted by relative risk factors, and both of the P value were below O. 05. Conclusions Posterior infarction was more prone to occur in the population of cerebral infarction with diabetes, diabetes was the independent risk factor of posterior infarction.