老年糖尿病颅内动脉流速异常与脑血管事件发生关系的研究

Relation of abnormal cerebral arterial blood velocity and cerebral vascular incident in DM elder patients

目的 评价经颅多普勒超声(TCD)检测老年糖尿病患者颅内动脉血流异常的预后价值。方法 对86例60-85岁老年2型糖尿病患者进行TCD检测并前瞻性随访69个月。结果本组老年糖尿病患者血流速度异常率较高,占60.5％,且以流速异常增高为主;随访期间,6例发生非脑血管病死亡,17例发生非致死性脑梗死,1例发生非致死性脑出血,2例发生一过性脑缺血发作(TIA)。所有20例发生脑血管事件的患者进入研究时,颅内动脉血流速度异常者脑血管事件发生率显著高于颅内动脉血流速度正常者(P<0.01)。在流速异常患者中2支或2支以上血管病变者较单支血管病变者更易发生脑血管病变(P<0.01)。结论老年糖尿病患者经颅多普勒超声检测颅内动脉血流速度异常对随后脑血管事件的发生有预测价值。

Objective To assess the prognostic value of abnormal cerebral arterial blood velocity among diabetes melltus (DM)patients elderly detected by transcranial doppler utrasonography( TCD) . Methods 86 cases of type 2 DM aged 60 to 85 were followed up for 69 months. Results The TCD results showed that the rate of abnormal cerebral arterial blood velocity among type 2 DM patients elderly was higher(60.5% ) ,most cases had abnormal increase cerebral arterial blood flow velocity. During the follow-up,nonfatal symptomatic cerebral infarction and cerebral hemorrhage were registered in 17 and 1 patients, transient ischemia attack (TIA) was registered in 2 patients ,6 patients died of causes other than cerebral vascular disease . The incidence on cerebral vascular incident in all the 20 patients were significantly higher in the patients with abnormal cerebral arterial blood velocity( P < 0.01) than the normal. And the incidence was significantly higher in the patients with 2 or over 2-vessels diseased ( P < 0.01) than those with 1-vessels diseased. Conclusion Transcranial doppler ultrasonographic detection of abnormal cerebral arterial blood velocity among type 2 DM patients elderly can be used to predict the cerebral vessels incident.