2型糖尿病合并脑梗死危险因素的配比病例对照研究  

A study on the risk factors of cerebral infarction as complication of type 2 diabetes mellitu patients

作　　者：孟庆和[1] 王建华[1] 王正伦[1] 宁宪嘉[2] 

机构地区：[1]天津医科大学公共卫生学院,300070 [2]天津医科大学总医院

出　　处：《中华流行病学杂志》2001年第3期208-211,共4页Chinese Journal of Epidemiology

摘　　要：目的　探讨 2型糖尿病合并脑梗死危险因素。方法　应用 1∶1配比的病例对照研究方法。应用条件logistic回归模型对资料进行分析。结果　文化程度与 2型糖尿病合并脑梗死有关。患 2型糖尿病以后 ,适当加强体育锻炼和劳动强度较大可以减小脑梗死发生的危险性。高密度脂蛋白 (HDL C)越高 ,2型糖尿病合并脑梗死的危险性越小。血糖控制以后 ,也可以降低 2型糖尿病合并脑梗死的危险性。上述因素为保护性因素。盐摄入过多可增加 2型糖尿病合并脑梗死的危险性。打鼾使 2型糖尿病患者发生脑梗死的危险性增加。高血压是 2型糖尿病合并脑梗死独立的危险因素。房颤是 2型糖尿病合并脑梗死的重要危险因素。A型性格与 2型糖尿病合并脑梗死有关 ,显示 2型糖尿病发生脑梗死有明显的个性特征存在。高胰岛素血症是 2型糖尿病发生脑梗死的危险因素。低密度脂蛋白 (LDL C)、载脂蛋白a [Lp(a) ]、纤维蛋白原 (Fg)水平增高 ,可以增加 2型糖尿病合并脑梗死的危险性。研究未发现吸烟、饮酒、口服避孕药、妊娠中毒症、总胆固醇 (TC)、甘油三酯 (TG)、Apo B与 2型糖尿病合并脑梗死有关。结论　为了控制 2型糖尿病合并脑梗死应提倡适当加强体育锻炼 ,多食蔬菜 ,控制盐的过多摄入 。Objective Cerebral infarction, a common acute cereovascular disease, is one of the main complications of type 2 diabetes mellitus (DM). This paper is to explore the risk factors of cerebral infarction among type 2 DM patients. Methods A pair matched case control study was carried out. Data was analyzed with conditional logistic regression. Results One hundred and ten type 2 DM patients with cerebral infarction and controls were selected respectively. Results showed that higher educational level and physical exercises lowered the risk of cerebral infarction among type 2 DM patients. Higher HDL C and blood sugar under control could also lower the risk of developing cerebral infarction among type 2 DM patients. The above factors seemed to have protective functions. Excessive salt intake and snoring increased the risks of cerebral infarction development among type 2 DM patients. Hypertension served as an independent risk factor while atrial fibrillation and hyperinsulinemia were important risk factors. High LDL C, Apo A , Lp(a), Fg increased the risk of cerebral infarction among type 2 DM patients. The study did not discover the relationship of smoking, drinking, oral contraception, menstrual and obstetrical history, TC, TG, Apo A and cerebral infarction among type 2 DM patients. Conclusion To prevent cerebral infarction among type 2 DM, measures need to be taken as control of salt intake; eating more vegetables; regular physical exercises; control of blood sugar, blood pressure and Hyperinsulinemia.

关 键 词：Ⅱ型糖尿病 非胰岛素依赖型 脑梗塞 条件LOGISTIC回归 

分 类 号：R195[医药卫生—卫生统计学]