糖尿病对缺血性脑卒中短期发病率影响的回顾性队列研究

Relationship between Diabetes Mellitus and the Short-term Incidence Rate of Ischemic Cerebrovascular Disease Based on a Retrospective Cohort Study

目的探索糖尿病与缺血性脑卒中短期发病率之间的关系,为脑卒中科学防治提供理论指导。方法采用回顾性队列研究方法于2017-06随机抽取上海市嘉定区社区居民,并按照是否患有糖尿病分成两组,调查所有研究对象年龄、性别、BMI、职业、吸烟、饮酒、喝茶、疾病史等基线资料,并通过脑卒中登记报告系统,以身份证号码为唯一识别码,收集所有研究对象脑卒中发病时间、疾病诊断和ICD编码病例类型、诊断医院、诊断依据、相关的检验和检查结果等资料和信息,采用多因素Logistic回归分析糖尿病对脑卒中发病的影响。结果共有8533例研究对象纳入队列,无糖尿病组7859例,糖尿病组共674例,队列中共有69例研究对象新发脑卒中,累计发病率8.09‰,未矫正时,糖尿病组发病风险是无糖尿病组的3.885(2.2346.756)倍(P<0.001),经年龄、BMI、喝茶、高血压等因素矫正后,糖尿病组发病风险是无糖尿病组的2.652(1.5004.691)倍(P=0.001)。结论糖尿病是缺血性脑卒中短期发病率的危险因素,应当加强糖尿病防治知识的健康教育,并规范糖尿病人随访管理,早期发现高危人群,及时予以干预,减少缺血性脑卒中发生风险。

Objective To explore the relationship between diabetes mellitus and incidence rate of ischemic cerebrovascular diseases so as to provide theoretical guidance for scientific prevention and treatment of stroke.Methods A retrospective cohort study was conducted to randomly select community residents in Jiading District,Shanghai in June 2017.Participants were divided into two groups based on whether they had diabetes or not.The baseline information was surveyed,including age,gender,BMI,occupation,smoking,drinking,drinking tea,and diseasehistory.Data about ischemic cerebrovascular diseases all the subjects,such as the time of onset of stroke,disease diagnosis and ICD-code,diagnostic hospital,diagnostic basis were collected through the stroke registration and reporting system.Multivariate Logistic regression was used to analyze the influence of diabetes mellitus on stroke.Results Totally,8533 subjects were included in the cohort,and 69 patients were identified with a cumulative incidence rate of 8.09‰.The risk of diabetes mellitus group was 3.885(2.234-6.756)times higher than that of non-diabetes mellitus group,and the risk of diabetes mellitus group was 2.652(1.500-4.691)times higher than that of non-diabetes mellitus group after adjusting for age and drinking tea.Conclusion Diabetes mellitus is an independent risk factor for ischemic cerebrovascular diseases.It is of a great significance to strengthen the health education of diabetes prevention and treatment knowledge,and standardize the follow-up management of diabetic patients,early detect of high-risk people,and timely intervention to further reduce the risk of future ischemic cerebrovascular disease.