论文部分内容阅读
目的探讨海南省老年2型糖尿病合并脑卒中的临床特点,并对其相关的危险因素进行分析。方法回顾性对海南省180例老年2型糖尿病合并脑卒中组、非糖尿病脑卒中组及糖尿病无卒中组的临床病历资料(患者的基本资料、体重指数、血压、血糖、糖化血红蛋白、空腹胰岛素、脂质代谢水平和临床表现等)进行分析比较。结果老年2型糖尿病并脑卒中患者中高血压的发生率(67%)高于非糖尿病脑卒中组及糖尿病无卒中组(P<0.05)。老年糖尿病合并脑卒中组以缺血性脑梗死多见(83%),更容易出现肢体偏瘫(P<0.01)和失语(P<0.05)。血脂、血糖、尿酸、纤维蛋白原的水平高于糖尿病无卒中组和非糖尿病脑卒中组(P<0.05)。采用Logistic逐步回归分析显示,体重指数、低密度脂蛋白胆固醇、收缩压和餐后血糖水平与脑梗死显著相关(OR分别为0.59、2.29、0.78、2.31和0.06)。结论老年糖尿病合并脑卒中时有特征性临床表现模式,血糖控制不佳,高血压、高血脂、高尿酸、高纤维蛋白原是老年2型糖尿病并发脑卒中主要危险因素,影响预后。
Objective To explore the clinical features of elderly type 2 diabetes mellitus and stroke in Hainan Province and to analyze the related risk factors. Methods The clinical data of 180 elderly patients with type 2 diabetes mellitus complicated with stroke, non-diabetic stroke and non-diabetic stroke in Hainan Province were retrospectively reviewed (basic data, body mass index, blood pressure, blood glucose, glycosylated hemoglobin, fasting insulin, Lipid metabolism and clinical manifestations, etc.) for analysis and comparison. Results The incidence of hypertension in elderly patients with type 2 diabetes mellitus and stroke was 67% higher than those in non-diabetic stroke and diabetic stroke-free group (P <0.05). Elderly patients with diabetes mellitus and stroke group were more common in ischemic cerebral infarction (83%), and were more likely to have limb hemiplegia (P <0.01) and aphasia (P <0.05). Blood lipids, blood glucose, uric acid and fibrinogen levels were higher than those in stroke-free and non-diabetic stroke patients (P <0.05). Logistic stepwise regression analysis showed that body mass index, low density lipoprotein cholesterol, systolic blood pressure and postprandial blood glucose levels were significantly associated with cerebral infarction (OR 0.59, 2.29, 0.78, 2.31, and 0.06, respectively). Conclusion Elderly patients with diabetes mellitus and stroke have characteristic clinical manifestations and poor blood sugar control. Hypertension, hyperlipidemia, hyperuricemia and hyperfibrinogen are the major risk factors for type 2 diabetes mellitus complicated with stroke in elderly patients and affect the prognosis.