糖尿病合并高血压患者脑微出血和脑梗塞的关系

The Relationship Between Cerebral Microbleeds and Cerebral Infarction in Diabetic Patients with Hypertension

目的探讨糖尿病合并高血压患者与脑微出血(CMBs)和脑梗塞的关系。方法选取2015年2月~2017年5月于江西省中西医结合医院接受治疗的急性期脑梗塞患者98例,根据有无糖尿病、高血压分为高血压合并糖尿病脑梗塞组(33例)、高血压脑梗塞组(35例)、糖尿病脑梗塞组(30例),同时选取于我院进行体检的健康志愿者(30例)组成健康组。所有入选者均接受全身磁共振扫描仪检查,观察糖尿病合并高血压脑梗塞患者脑微出血SWI表现,比较三组CMBs分级,分析CMBs分级与糖尿病合并高血压相关性分析。结果经影像学检查显示,糖尿病合并高血压患者发生脑梗塞后,脑微出血情况与单纯糖尿病脑梗塞患者、高血压脑梗塞患者、健康者比较椭圆形低信号区明显增强;高血压合并糖尿病脑梗塞组CMBs3级、4级发生率高于高血压脑梗塞组、糖尿病脑梗塞组(P<0.05);经Spearman相关性分析发现,CMBs分级与糖尿病合并高血压呈正相关(r=0.364,P=0.183)。结论急性期脑梗塞患者合并糖尿病和高血压疾病可增加CMBs分级,通过对患者糖尿病、高血压疾病的控制,可对患者发生CMBs预防及治疗提供指导。

Objective To investigate the relationship between patients with diabetes and hypertension and cerebral microbleeds(CMBs)and cerebral infarction.Methods A total of 98 patients with acute cerebral infarction who were treated in Jiangxi Hospital of Integrated Traditional Chinese and Western Medicine from February 2015 to May 2017 were selected.According to the presence or absence of diabetes and hypertension,they were divided into hypertension and diabetic cerebral infarction group(33 cases),The hypertensive cerebral infarction group(35 cases),the diabetic cerebral infarction group(30 cases),and healthy volunteers(30 cases)who underwent physical examination in our hospital were selected to form the healthy group.All selected subjects were examined by whole-body magnetic resonance scanner to observe the SWI performance of cerebral microbleeds in patients with diabetes and hypertensive cerebral infarction,compare the three groups of CMBs classification,and analyze the correlation between CMBs classification and diabetes with hypertension.Results The imaging examination showed that after cerebral infarction in diabetic patients with hypertension,the situation of cerebral microbleeds was significantly enhanced compared with patients with simple diabetic cerebral infarction,hypertensive cerebral infarction patients,and healthy people;the oval low signal area was significantly enhanced;hypertension complicated with diabetic cerebral infarction the incidence of CMBs grade 3 and 4 in the group was higher than that of the hypertensive cerebral infarction group and the diabetic cerebral infarction group(P<0.05);Spearman correlation analysis showed that the CMBs grade was positively correlated with diabetes and hypertension(r=0.364,P=0.183).Conclusion Patients with acute cerebral infarction combined with diabetes and hypertension could increase the classification of CMBs.Through the control of diabetes and hypertension,it could provide guidance for the prevention and treatment of CMBs in patients.