糖尿病合并急性脑梗死患者的颅内血管病变特点  

Characteristics of Intracranial Vascular Lesions in Patients with Diabetes Mellitus Combined with Acute Cerebral Infarction

作　　者：吴志强[1] 李润雄[1] 罗根培[1] 王世芳[1] WU Zhi-qiang;LI Run-xiong;LUO Gen-pei(Dongguan People＇ s Hospital,Guangdong 523059,China)

机构地区：[1]广东省东莞市人民医院神经内科,523000

出　　处：《心脑血管病防治》2018年第4期289-291,共3页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

基　　金：广东省东莞市科技局立项课题(编号:201010515000076)

摘　　要：目的探讨糖尿病合并急性脑梗死患者的颅内血管病变特点。方法选取在本院治疗的脑血管病患者全脑血管造影(DSA)共246例,根据是否患有糖尿病分为观察组和对照组,观察组128例、对照组118例。对所有患者行头颅磁共振MRI+DWI+MRA检查明确脑梗死,再根据颅内血管情况行DSA,根据检查结果对脑血管病变情况进行汇总统计。对比观察组与对照组颅内血管病变情况。结果观察组患者血管狭窄785处,多于对照组患者血管狭窄411处,差异有统计学意义(P<0.05);观察组患者血管狭窄率大于对照组患者血管狭窄率,差异有统计学意义(P<0.05)。观察组患者血管狭窄前循环453处,后循环332处,前后循环狭窄数对比差异有统计学意义(P<0.05);对比观察组与对照组患者颅内侧枝循环开放情况,观察组患者侧枝开放率为46.87%,对照组患者侧枝开放率为88.98%,观察组患者侧枝开放率显著低于对照组,差异有统计学意义(P<0.05)。对比患糖尿病不同时长患者血管病变情况,患病时间越长血管狭窄率越高,狭窄程度越严重,侧枝开放率越低,整体状况越差。结论糖尿病患者颅内血管状况比未患糖尿病患者血管状况差,糖尿病作为急性脑梗死的独立危险因素,对血管病变有较大的影响。Objective To investigate the characteristics of intracranial vascular lesions in patients with diabetes mellitus and acute cerebral infarction. Methods 246 patients with cerebrovascular disease undergoing cerebrovascular angiography in our hospital,were included and divided into study group（ 118 cases） and control group（ 128 cases） according to whether there were diabetes. All patients underwent head MRI,DWI and MRA to diagnose cerebral infarction. Intracranial vascular lesions in study group and control group were compared. Results There were significant differences in vascular stenosis between the study group and the control group（ 785 vascular stenosis in studygroup,411 in the control group,P 0. 05）,the rate of stenosis was also different（ P 0. 05）. There were significant differences in the number of stenosis of anterior circulation（ 453 in study gourp） and posterior circulation（ 332 in study gourp） between two groups（ P 0. 05）. The open rate of collaterals in the study group（ 88. 98%） was significantly lower than that in the control group（ 46. 87%）（ P 0. 05）. In patients with different duration of diabetes,the longer the duration of the disease the higher the rate of vascular stenosis,the more serious the degree of stenosis,the lower the rate of collateral openness,the worse the overall condition. Conclusions The intracranial vascular status of diabetic patients is worse than that of non-diabetic patients. Diabetes mellitus,as an independent factor of acute cerebral infarction,impact greatly on vascular lesions.

关 键 词：糖尿病 急性脑梗死 血管病变 

分 类 号：R578.1[医药卫生—消化系统] R743.3[医药卫生—内科学]