糖尿病病程与脑卒中发病风险的关系  

Influence of hyperbaric oxygen on prognosis of different brain tumors

作　　者：陈厚斌[1] 韩肇木[1] 喻佛定[1] 尹婉凌 白兴平[1] 

机构地区：[1]武汉市中心医院内一科,湖北武汉430014

出　　处：《中国现代医学杂志》2015年第2期68-72,共5页China Journal of Modern Medicine

摘　　要：目的 探讨糖尿病病程与卒中发生风险之间的相关性。方法 大约有3 298例卒中患者参与该研究,收集基线处糖尿病患者和糖尿病确诊时的年龄。每年对糖尿病发病率进行评估（中位数=9年）。Cox比例风险模型用于评估风险比例和95%置信空间（HR,95%CI）,同时使用糖尿病基线的95%置信空间（HR,95%CI）用于缺血性中风发生率。结果 平均年龄为（69±10）年;在基线处22%为糖尿病患者且10%发展为糖尿病。244例为缺血性中风,且基线糖尿病（HR=2.5,95%CI=1.9～3.3）和糖尿病作为时依变量（HR=2.4,95%CI=1.8～3.2）与卒中发生风险的关系相似。糖尿病病程与缺血性中风相关（调整患有糖尿病的HR=1.03/每年,95%CI=1.02～1.04）。与非糖尿病参与者相比,那些患有0～5年的糖尿病（调整HR=1.7,95%CI=1.1～2.7）,5～10年（调整HR=1.8,95%CI=1.1～3.0）,且≥10年（调整HR=3.2,95%CI=2.4～4.5）则增加其危险性。结论 糖尿病病程是缺血性卒中的独立风险因素。缺血性卒中发生风险每年增加3%,当糖尿病病程超过10年后,其风险增加3倍。[Objective] To investigate the relativity between diabetes duration and stroke risk. [Methods] Among 3,298 stroke participants in Zhangjiajie City, baseline diabetes and age at diagnosis were determined. Incident diabetes was assessed annually （median = 9 years）. Cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals （HR, 95%CI） for incident ischemic stroke using baseline diabetes, diabetes as a time-dependent covariate, and duration of diabetes as a time-varying covariate; models were adjusted for demographic and cardiovascular risk factors. [Results] The mean age was （69 ± 10） years; 22% were diabetic at baseline and 10% developed into diabetes. There were 244 ischemic strokes, and both baseline diabetes （HR = 2.5, 95%CI = 1.9- 3.3） and diabetes considered as a time-dependent covariate （HR = 2.4, 95% CI 1.8-3.2） were similarly associated with stroke risk. Duration of diabetes was associated with ischemic stroke （adjusted HR = 1.03 per year with diabetes, 95%CI = 1.02 - 1.04）. Compared to non-diabetic participants, those with diabetes for 0 ～ 5 years （adjusted HR = 1.7, 95%CI = 1.1 ～ 2.7）, 5 ～ 10 years （adjusted HR = 1.8, 95%CI = 1.1- 3.0）, and t〉10 years （adjusted HR = 3.2, 95%CI = 2.4 ～ 4.5） were at increased risk. [Conclusion] Duration of diabetes is independently associated with ischemic stroke risk adjusting for risk factors. The risk increases 3% each year, and triples with diabetes ≥ 10 years.

关 键 词：糖尿病 缺血性中风 流行病学 风险因素 

分 类 号：R587.1[医药卫生—内分泌]