2型糖尿病合并急性脑梗死的血管损害及临床预后  

The blood vessel damage and clinical prognosis in patient with type 2 diabetes mellitus and acute cerebral infarction

作　　者：薛桦[1] 董秦川 王成太 

机构地区：[1]陕西省宝鸡市中医医院脑病二科,721001

出　　处：《中国综合临床》2016年第4期299-301,共3页Clinical Medicine of China

摘　　要：目的探讨T2DM对急性脑梗死的血管损害特点及对近期预后的影响。方法选取156例急性脑梗死患者，分为T2DM组64例和非T2DM组92例，进行全脑血管造影，对其结果和急性脑梗死治疗的结果、预后进行分析。结果T2DM组的颅内动脉血管狭窄发生率为79．69％（51／64），非T2DM组的颅内动脉血管狭窄发生率为58．70％（54／92），组间比较差异有统计学意义（χ2=12．856，P〈0．05），且T2DM组颅内外动脉狭窄并存、前后循环狭窄并存的发生率分别为50．00％（32／64）、59．36％（38／64），非T2DM组颅内外动脉狭窄并存、前后循环狭窄并存的发生率分别为21．74％（20／92）、29．35％（27／92），组间比较差异有统计学意义（χ2值分别为9．652、8．659，P均〈0．05）；T2DM组多支病变、弥漫性病变及无侧支代偿发生率分别为71．88％（46／64）、65．63％（42／64）、71．88％（46／64），非T2DM组多支病变、弥漫性病变及无侧支代偿发生率分别为54．35％（50／92）、39．13％（36／92）、31．52％（29／92），组间比较差异有统计学意义（χ2值分别为8．625、9．354、11．053，P均〈0．05）；入院2周T2DM组治疗总有效率为46．88％（30／64），非T2DM组为90．22％（83／92），组间比较差异有统计学意义（χ2=8．061，P〈0．05）。结论合并T2DM的缺血性脑血管病患者颅内动脉狭窄发生率较对照组高，病变范围广泛，呈弥漫性损害，血管损害中重度狭窄及闭塞均明显高于非T2DM组，尤其无侧支代偿发生率高于非T2DM组，T2DM组的神经功能损害更重，预后更差。Objective To explore the effect of type 2 diabetes mellitus （T2DM） on vascular damage characteristics of acute cerebral infarction and the impact on the short term prognosis. Methods One hundred and fifty-six cases of acute cerebral infarction patients were selected and divided into the T2DM group with 64 cases and non-T2DM group with 92 examples. According to the whole cerebral angiogram, the results and the results of the treatment of acute cerebral infarction and prognosis were analyzed. Results The incidence of intracranial aryery stenosis of the T2DM group was 79. 69% （ 51/64） , of non-T2DM group was 58.70% （54/92） , the difference between two groups was significant （χ2 = 12. 856, P〈 0. 05） . The incidence of before and after intracranial artery stenosis coexist, circulation narrow coexist in T2DM group was 50.00% （32/64） , 59. 36% （38/64） respectively, in non-T2DM group was 21.74% （20/92） , 29. 35% （27/92） respectively, the difference between groups was significant（ χ2= 9. 652,8. 659; P〈0. 05） . The incidence of muhivessel lesions and diffuse lesions and without collateral compensatory in T2DM group was 71.88% （46/64） ,65.63% （42/64） and 71.88%（46/64） respectively,in non-T2DM group was 54. 35%（59/92） ,39. 13%（36/92） and 31.52%（29/ 92） respectively, the difference between groups was significant （ χ2 = 8. 625,9. 354,11. 053 ; P〈0.05） . The total effective rate after 2 weeks of treatment in T2DM group was 46. 88% （30/64） , in non-T2DM group was 90. 22% （83/92） , the difference between groups was significant（ χ2= 8. 061 ,P〈01 05） . Conclusion The incidence of intracranial artery stenosis in patients with intracranial artery stenosis combined with T2DM is higher than the control group, and lesion range widely, diffuse damage, vascular damage moderately severe stenosis and occlusion are significantly higher than in non-T2DM group, especially without collateral compensatory rates is higher than non-T2DM group, while the neural

关 键 词：糖尿病 脑梗死 脑血管造影 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]