2型糖尿病与急性脑梗死患者预后的关系  

Effect of type 2 diabetes on prognosis in patients with acute brain infarction

作　　者：李慎军[1] 王树才[1] 谷明明[1] 曹秉振[1] 

机构地区：[1]解放军济南军区总医院神经内科,山东济南250031

出　　处：《解放军医学院学报》2016年第2期125-127,150,共4页Academic Journal of Chinese PLA Medical School

摘　　要：目的探讨2型糖尿病（type 2 diabetes mellitus,T2DM）与急性脑梗死患者长期预后的关系。方法连续纳入2010年8月-2014年8月于济南军区总医院神经内科住院的急性脑梗死患者的临床资料。按照有无T2DM将患者分为两组,在发病后180 d通过电话进行随访,采用改良Rankin量表（m RS）评分对患者的预后进行评价（m RS评分≤2分为预后良好,m RS评分〉2分为预后不良）。采用多元回归分析T2DM对急性脑梗死患者预后不良和病死率的影响。结果共纳入1 138例急性脑梗死患者,T2DM组417例,其中男性253例,年龄（63.40±11.26）岁;非T2DM组721例,其中男性460例,年龄（64.48±12.92）岁。非T2DM急性脑梗死患者预后良好（m RS≤2分）484例,预后不良（m RS〉2分）237例;伴T2DM急性脑梗死患者预后良好（m RS≤2分）247例,预后不良（m RS〉2分）170例。伴T2DM急性脑梗死患者预后不良比例（40.77%）显著高于非T2DM急性脑梗死患者（32.87%）（χ2=7.700,P=0.006）。结论 T2DM是急性脑梗死患者预后不良（OR=1.997,95%CI：1.414~2.281,P=0.000）的独立危险因素。Objective To investigate the effect of type 2 diabetes（T2DM） on prognosis in patients with acute brain infarction. Methods Clinical data about consecutive acute cerebral infarction patients who were hospitalized in department of neurology in General Hospital of Jinan Military Region were prospectively recruited from August 2010 to August 2014, including age, sex, National Institute of Health Stroke Scale（NIHSS） score, type of Oxfordshire Community Stroke Project（OCSP： total anterior circulation infarct, partial anterior circulation infart, posterior circulation infarct and lacunar infarct）, serum creatinine, with or without T2 DM, fasting blood glucose within 24 hours after admission were recorded. Patients were divided into two groups according to with or without T2 DM. Recovery was assessed by modified Rankin Scale（m RS） at 180 days after stroke by telephone interview（m RS≤2 reflected good prognosis, and m RS2 reflected unfavorable prognosis）. Multinominal logistic regression analysis was used for investigating the effect of T2 DM on prognosis. Results Of the 1 138 patients, 417 patients had T2 DM, among them 253 patients were male with average age of（63.40±11.26） years; 721 patients did not have T2 DM, among them 460 patients were male with average age of（64.48±12.92） years. In patients without T2 DM group, 484 cases had good prognosis with m RS≤2 and 237 cases had unfavorable prognosis with m RS2. However, in patients with T2 DM group, 247 cases had good prognosis with m RS≤2 and 170 cases had unfavorable prognosis with m RS2. The unfavorable prognosis rate of patients with T2 DM was significantly higher than patients without T2DM（40.77% vs 32.87%, χ2=7.700, P=0.006）. Conclusion T2 DM was an independent prognostic factor for long-term poor outcome（OR=1.997, 95% CI： 1.414-2.281, P=0.000）.

关 键 词：2型糖尿病 脑梗死 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]