脑梗死合并代谢综合征与单纯脑梗死临床特点、近远期预后及相关影响因素比较

Comparison of Clinical Features and Short-and Long-term Prognosis between Simple Cerebral Infarction and Cerebral Infarction with Metabolic Syndrome

[目的]比较脑梗死合并代谢综合征与单纯脑梗死临床特点和近远期预后,并探讨预后相关影响因素.[方法]选择2010年5月至2016年5月本院收治的328例脑梗死患者作为研究对象,根据是否合并代谢综合征将其分为代谢综合征组( n =182例)和单纯脑梗组( n =146例).比较两组临床特点和近远期预后,采用Logis‐tic回归分析探讨影响近远期预后的因素.[结果]两组在性别、年龄、体质量指数(BM I)、高血压患病情况及分级、糖尿病患病情况、空腹血糖(FBG)、空腹胰岛素(Fins)、胰岛素抵抗指数(HOM A‐IRI)、糖化血红蛋白(HbA1C )、血脂四项、同型半胱氨酸(HCY )、颈动脉内中膜厚度(IM T )增厚、T OAST 分型、并发症及住院时间(LOS )等临床特点上差异明显,有统计学意义( P <0 .05),但在吸烟、饮酒和脑梗死部位上差异无统计学差异( P >0 .05).与单纯脑梗组比较,代谢综合征组近期有效率明显降低,而远期残疾率和复发率则明显升高,差异有统计学意义(P<0 .05).经Logistic回归分析得知,高血压分级(3级)、HbA1C 、TOAST分型(LAA型)、并发症(肺栓塞)及代谢综合征是影响脑梗死近期预后的关键因素( P <0 .05);IM T增厚、脑梗死部位(枕叶)、并发症(肺栓塞)及代谢综合征是影响脑梗死残疾的关键因素( P <0 .05),而并发症(肺栓塞)和代谢综合征则是影响脑梗死复发的关键因素( P <0 .05).[结论]脑梗死合并代谢综合征和单纯脑梗死临床特点和近远期预后差异明显,其中合并代谢综合征是影响其预后的关键因素.

[Objective]To compare clinical characteristics ,short‐term and long‐term prognosis between simple cerebral infarction and cerebral infarction with metabolic syndrome to explore the related factors of prognosis .[M ethods]T he clinical data of 328 patients with cerebral infarction admitted to our hospital from M ay 2010 to M ay 2016 were retrospectively analyzed .According to w hether or not they had metabolic syndrome ,they were divided into the metabolic syndrome complication group (182 cases) and simple cerebral infarction group (146 cases) ,re‐spectively .T he clinical characteristics and short‐term and long‐term prognosis of the two groups were compared and analyzed .T he key factors affecting the short‐term and long‐term prognosis were discussed by logistic regres‐sion analysis .[Results]T here were significant differences in gender ,age ,BM I ,prevalence and classification of hy‐pertension ,diabetes mellitus ,FBG ,Fins ,HOM A‐IRI ,HbA1C ,blood lipids ,HCY ,IM T thickening ,T OAST classification ,complications and LOS between the two groups ( P <0 .05).However ,there were no significant differences of cerebral infarction sites with smoking and drinking ( P >0 .05).Compared to the simple cerebral in‐farction group ,the short‐term effective rate was significantly lower in the cerebral infarction with metabolic syn‐drome group ,while the long‐term disability rate and recurrence rate were significantly higher ( P <0 .05).T he Lo‐gistic regression analysis showed that hypertension classification (grade three ) , HbA1C , T OAST classification (LAA ) ,complications (pulmonary embolism ) and metabolic syndrome were the key factors affecting the short‐term prognosis of cerebral infarction ( P <0 .05);IM T thickening ,infarction site (occipital lobe ) ,complications (pulmonary embolism ) and metabolic syndrome were the key factors affecting cerebral infarction disability ( P <0 .05) ,and complications (pulmonary embolism ) and metabolic syndrome were the key factors affecting the recur‐rence of cerebral infarction ( P <0 .05).[Conclusion]T here are significantly different in terms of clinical character‐ istics and long‐term prognosis in patients with simple cerebral infarction and cerebral infarction complicated with metabolic syndrome.T he metabolic syndrome is the key factor affecting the prognosis of cerebral infarction .