老年2型糖尿病合并脑梗死的病变特点及临床危险因素分析(1)
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【摘要】 目的 探讨老年2型糖尿病合并脑梗死患者的病变特点,并对其临床相关危险因素进行分析。方法 随机选择老年2型糖尿病合并脑梗死118例,无脑梗死2型糖尿病患者130例,分析其脑梗死特点。所有病例均统计年龄、性别、腹围、体重指数、血压、血脂、血糖、糖化血红蛋白,对其进行分析,及两组比较。结果 老年2型糖尿病合并脑梗死患者以再发性、多灶性腔隙性脑梗死及大面积脑梗死多见。采用Logistic逐步回归分析显示,年龄、收缩压、低密度脂蛋白胆固醇、餐后高血糖与脑梗死显著相关。结论 高龄、高血压、高血脂、高血糖、高胰岛素血症、吸烟是糖尿病合并脑梗死的独立危险因素,老年糖尿病患者应加强对血糖、收缩压、血脂、不良生活习惯等危险因素进行早期干预及良好控制,以减少和延缓脑梗死的发生与发展。
【关键词】
糖尿病;脑梗死;危险因素;老年人
The clinical features and the risk factor profile of ischemic infarction in elderly type2 diabetes
【Abstract】 Objective Find out the clinical features and evaluate the risk factor profile of ischemic infarction in elderly type2 diabetes.Methods We have randomly enrolled 118 type2 elderly diabetes patients with ischemic infarction and 130 subjects without infarction.We anamnestically evaluated the features of ischemic infarction records.The correlated indicators we recorded include:age,waist circumference,Body Mass Index(BMI),smoking habit,systolic pressure,blood sugar,glycosylated hemoglobin,triglyceride,lowdensity lipoprotein cholesterol,highdensity lipoprotein cholesterol.These indicators were analyzed and compared in the two groups.Results Type2 Diabetes in elderly people was mostly associated with recurrent multifocal lacunar infarction and large areacerebral infarction.Using conditional logistic regression analysis,we find that the association of age,systolic pressure,low density lipoprotein cholesterol,postprandial glucose with ischemic infarction in diabetes remained statistically significant after adjustment.Conclusion Our study shows old age,hypertention,hyperlipemia,high blood glucose,hyperinsulinemia and smoking are independent risk factors of ischemic infarction in type2 diabetes.Early synthetic prevention and control of these risk factors should be adopted in the elderly with diabetes to decrease the incidence of ischemic infarction and prolong its development.
【Key words】
Type 2 diabetic mellitus; Cerebral infarction; Risk factors; Aged
DOI:10.3760/cma.j.issn 16738799.2010.01.69
作者单位:432900湖北省孝昌县第一人民医院二内科
由于社会经济的发展和医疗条件的改善,目前我国大于60岁的年老人已超过总人口的10%。而糖尿病的发生与人口老年化,生活方式城市化,肥胖人口的增多,以及运动减少有密切关系 ......
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