老年高血压缺血性脑卒中合并2型糖尿病患者颈动脉粥样硬化程度的分析  

Carotid atherosclerosis in elderly hypertensive ischemic stroke patients with type 2diabetes mellitus

作　　者：刘国荣[1] 高素玲[1] 张江[1] 张文丽[1] 郭静[1] 陈瑞英[1] 李倩[1] 王大力[1] 

机构地区：[1]河北联合大学附属医院神经内科,唐山063000

出　　处：《中华老年心脑血管病杂志》2013年第6期607-610,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：唐山市科技局资助项目(12150222B-13)

摘　　要：目的应用CT血管成像联合颈动脉超声检查对颈动脉粥样硬化斑块进行评价,并探讨其与2型糖尿病的关系。方法选择缺血性脑卒中患者152例,根据诊断分为糖尿病组56例,非糖尿病组96例,并进行CT血管成像联合颈动脉超声检查,分析斑块性质、形态,观察发生缺血性脑卒中事件相关因素,logistic回归分析老年缺血性脑卒中颈动脉粥样硬化程度与糖尿病的相关性。结果与非糖尿病组比较,糖尿病组颈动脉内膜中层增厚及斑块发生率高,易损斑块多,颈总动脉分叉部及动脉狭窄比例高,差异有统计学意义(P<0.05)。logistic回归分析表明,空腹血糖(OR=5.924,95%CI:1.176～2.468,P=0.003)与颈动脉粥样硬化程度密切相关;LDL-C(OR=2.283,95%CI:1.108～4.276,P=0.009)、纤维蛋白原(OR=1.856,95%CI:1.287～3.095;P=0.011)与颈动脉粥样硬化程度相关。结论老年缺血性脑卒中合并2型糖尿病患者颈动脉粥样硬化程度重,危险因素多于非糖尿病患者;常规对于颈动脉粥样硬化患者进行定期的血糖检测有重要参考价值。Objective To study the correlation between carotid atherosclerotic plaques and type 2 diabetes mellitus （DM）. Methods One hundred and fifty-two ischemic stroke patients were divid- ed into DM group （n=56） and non-DM group （n=96） according to their diagnosis. The patients underwent CTA and carotid ultrasonography. The nature and morphology of carotid atheroscle- rotic plaques were analyzed,and the relative factors for ischemic cerebrovascular events were ob- served. The correlation between carotid atherosclerosis and DM was analyzed by logistic regres- sion analysis. Results The carotid IMT and the incidence of carotid atherosclerotic plaques were significantly higher,the number of vulnerable plaques was greater,and the proportion of stenoses in common carotid artery bifurcate and carotid artery was higher in DM group than in non-DM group （P〈0.05）. Logistic regression analysis showed that the serum levels of fasting glucose, LDL-C and fibrinogen were closely related with the carotid atherosclerosis （OR=5. 924,95 %CI： 1.176--2.468,P=0. 003;0R=2. 28,95%CI：1. 108--4. 276,P=0. 009;OR= 1. 856,95%CI： 1. 287--3. 095,P=0. 011）. Conclusion Crotid atherosclerosis is severer and the number of risk factors is greater in elderly ischemic stroke patients with type 2 DM than in those without DM. Regular blood glucose testing contributes greatly to the diagnosis of carotid atherosclerosis.

关 键 词：高血压 卒中 糖尿病 2型 颈动脉疾病 超声检查 多普勒 经颅 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]