2型糖尿病患者慢性并发症与脑卒中发病的关系  

A study on the relationship between chronic complications of type 2 diabetic and stroke incidence

作　　者：朱秋荣[1] 徐惠庆[1] 骆田斌[1] 余梦华[1] 

机构地区：[1]嘉兴市秀洲区疾病预防控制中心,浙江嘉兴314000

出　　处：《预防医学》2017年第4期351-354,共4页CHINA PREVENTIVE MEDICINE JOURNAL

摘　　要：目的分析2型糖尿病(T2DM)患者慢性并发症与脑卒中发病的关系。方法从浙江省慢性病监测管理信息系统导出2009—2014年嘉兴市秀洲区T2DM病例资料,主要包括患者基本信息、糖尿病慢性并发症和脑卒中发病情况。采用Logistic回归模型分析T2DM患者慢性并发症与脑卒中发病的关系。结果共纳入T2DM患者6 108例,新发脑卒中462例,占7.56%;479例(7.84%)在糖尿病确诊时已出现慢性并发症,其中116例发生脑卒中,发生率为24.21%,高于无慢性并发症者6.15%(P<0.05)。各类型慢性并发症中血管病变比例最高,占33.33%;其次为肾脏病变和神经病变,分别占24.64%和23.23%;视网膜病变和皮肤感染分别占13.48%和5.32%。多因素Logistic回归分析显示,在调整性别、发病年龄、职业、城乡、肥胖、高血压和高血脂等因素后,血管病变(OR=4.95,95%CI:3.41~7.19)和神经病变(OR=2.79,95%CI:1.80~4.32)是T2DM患者发生脑卒中的危险因素;伴有慢性并发症是T2DM患者发生脑卒中的危险因素,伴有1、2、3项并发症的OR值分别为1.28、2.75、5.38。结论 T2DM患者在确诊时所伴有的血管病变和神经病变是导致脑卒中发病的危险因素,合并慢性并发症数量越多发生脑卒中的风险越大。Objective To learn the relationship between chronic complications of type 2 diabetic and stroke incidence.Methods Based on the surveillance data of type 2 diabetes and stroke in Xiuzhou district of Jiaxing City from 2009 to2014,using logistic regression model method to analysis the relationships between chronic complications of type 2 diabetic and stroke incidence. Results Among 6 108 participants,462 subjects developed stroke（ 7. 56%）; 479（ 7. 84%）diabetes patients were diagnosed with chronic complications simultaneously and 116 subjects developed stroke（ 24. 21%）,higher than those no chronic complications（ 6. 15%,P 〈 0. 05）. The proportion of diabetic vasculopathy,nephropathy,neuropathy,retinopathy and skin infection were 33. 33%,24. 64%,23. 23%,13. 48% and 5. 32%,respectively. After adjusted for gender,age,occupation,urban and rural,obesity,hypertension and hyperlipidemia,there were significant statistical correlations between vasculopathy,neuropathy and stroke,the OR values and 95% CI were 4. 95（ 3. 41-7. 19）and 2. 79（ 1. 80-4. 32）; patients who combined with any one,two,three or more chronic complications were significantly associated with the onset of stroke when compared with those without chronic complication,the OR values were 1. 28,2. 75 and 5. 38,respectively. Conclusion Vasculopathy and neuropathy of type 2 diabetes patients which found at diagnosed were risk factors of stroke,and the more for type 2 diabetes patients combined with the chronic complications,the greater the risk of stroke.

关 键 词：2型糖尿病 脑卒中 慢性并发症 

分 类 号：R587.1[医药卫生—内分泌] R743.3[医药卫生—内科学]