糖尿病对缺血性卒中的复发与预后的影响

The observation of the recurrence and prognosis of ischemic stroke in diabetic patienls

目的 探讨糖尿病 (DM )对缺血性卒中的复发及预后的影响。 方法 收集并分析19 99年 11月～ 2 0 0 1年 10月间在我院住院的 3 18例缺血性卒中患者资料 ;应用MRI弥散加权图像技术 ,比较缺血性卒中伴DM (70例 )与不伴DM (2 48例 )患者的梗死灶部位和大小 ;随访两组患者出院后的卒中复发率和死亡率。 结果 DM组中腔隙性梗死远多于非DM组 (P <0 .0 1) ,但梗死部位两组间差异无显著意义 (P >0 .0 5)。生存分析显示缺血性卒中伴DM者累积卒中复发率明显高于不伴DM者 (P <0 .0 1,Log rank检验 ) ;两组累积死亡率差异无显著意义 (P >0 .0 5,Log Rank检验 )。COX风险模型结果表明 ,有DM史的缺血性卒中患者 ,复发的相对危险度为 2 .82。本研究结果表明 ,DM病程 5年以上者容易卒中复发 (P <0 .0 5)。 结论 DM不仅影响缺血性卒中的病灶大小 ,而且会明显增加卒中复发的风险。病程

ObjectiveTo explore the effect of diabetes melli tus (DM) on the clinical characteristics and the prognosis of patients with isch emic stroke.MethodsA retrospective study was performed to an alyze the clinical characteristics of all patients with ischemic stroke who were hospitalized from November 1999 to October 2001 in the department of neurology. Diffusion weighted image (DWI) of MRI was used to compare the location and size of lesions in ischemic stroke patients with and without DM. All patients were f ollowed to learn about the rate of recurrent stroke and the survival rate after hospitalization.ResultsThe history of DM was strongly associ ated with the size of new infarctive lesions on DWI (P<0.01), but not with t he localization(P>0.05). Life table analysis revealed that the recurrent s troke rate was significantly higher in patients with DM than in those without DM (P<0.01,Log Rank test), but no relationship was found between the surviv al rate the history of DM (P>0.05,Log Rank test). Cox proportional hazards model showed the OR of recurrent stroke rate was 2.8 in patients with DM. We al so found the patients with a history of DM over 5 years were more likely to get recurrent stroke compared with those less than 5 years(P<0.05).C onclusionOur study demonstrated that DM can not only effect on the siz e of cerebral infarcts but also the recurrent stroke rate in patients with ische mic stroke; and the recurrent stroke rate may also be associated with the durati on of DM.