脑梗死与代谢综合征的相关性研究  

Correlation study of different types of cerebral infarction and metabolic syndrome

作　　者：刘清阁[1] 利玉欢[1] 李飞[1] 潘志信[1] 何国雄[1] 

机构地区：[1]南方医科大学附属南海医院神经内科,佛山528000

出　　处：《中国实用神经疾病杂志》2010年第11期4-7,共4页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨代谢综合征(metabolic syndrome,MS)及其各单一组分危险因素对不同类型脑梗死(cerebral infarction,CI)的影响。方法选择符合纳入标准的脑梗死454例,其中血栓性脑梗死(cerebral thrombosis,CT)244例,腔隙性脑梗死(lacunar infarct,LI)210例及对照组300例。分析各组MS的患病率,MS及其各单一组分危险因素与不同类型脑梗死的相关性。结果 (1)脑梗死组MS患病率50.22%(228/454),CT组及LI组分别为54.10%(132/244)、45.71%(96/210),均显著高于对照组25.33%(76/300)。(2)CT组除肥胖外,MS各单一组分危险因素的患病率均高于对照组,LI组仅高血压、高血糖、甘油三酯(TG)增高及高密度脂蛋白胆固醇(HDL-C)降低的患病率高于对照组,且两类脑梗死的高血糖、高血压患病率有显著差异。(3)调整年龄、性别和其他脑卒中危险因素后,代谢综合征依然增加脑梗死患病的危险,按CDS标准对上述两类脑梗死的OR值分别为2.84(95%CI:1.85～5.62)、2.02(95%CI:1.32～4.13)。(4)两类脑梗死的胰岛素抵抗指数均(HOMAIR)高于对照组,随着组成MS危险因素的增加,HOMAIR逐渐升高。结论 MS与脑梗死患病危险增加相关,这种关系独立于脑卒中的其他危险因素。MS及其各单一组分的危险因素对不同类型脑梗死所起作用有所差别。MS的发生与胰岛素抵抗有关。Objective To investigate the effects of metabolic syndrome（MS） and its component risk factors on different types of cerebral infarction.Methods Total 454 patients with cerebral infarction were selected.Among them,there were 244 patients with cerebral thrombosis（CT）,and 200 patients with lacunary infarct（LI）,300 subjects as the control group.The prevalence of MS in all groups,and the correlation between its individual risk factors with different subtypes of cerebral infarction were analyzed.Results ① The prevalence of MS in CI group s was 50.22%,and 54.10% in CT group and 45.71% in LI group,respectively.They all were significantly higher than those in control group（25.33%）.② The prevalence of MS and its component risk factors in CT group were all significantly higher than those in control group but abdominal obesity.The prevalence of hypertension,and high blood glucose,and triglyceride（TG）,and low high-density lipoprotein cholesterol（HDL-C） in LI group were significantly higher than those in the LI group.The prevalence of hypertension and high blood glucose between the two CI subtypes were significantly different.③ After age and sex and smoking adjusted and further adjusted component risk factors of MS,the MS defined by CDS criteria was associated with a 1.85 to 5.62 fold and 1.32 to 4.13 fold higher risk of the two CI subtypes,respectively.④The HOMAIR of the two CI subtypes was significantly higher than that in LI group.The HOMAIR was increasing step by step along with increasing number of components constituting the MS.Conclusion The MS is positively associated with the risk of CI in our case control study.Effects of MS and its component risk factors on different types of cerebral infarction are different.The occurrence of MS is related with RI.

关 键 词：脑梗死 代谢综合征 胰岛素抵抗 

分 类 号：R743.33[医药卫生—神经病学与精神病学]