代谢综合征与老年急性脑梗死患者1年预后的关系研究  

Relationship between metabolic syndrome and 1-year prognosis of elderly patients with acute cerebral infarction

作　　者：秦一凡 高素颖 王拥军[3] 冀瑞烨 徐丽华 刘璇 耿颂 王洪涛 秦尚敏 Qin Yifan;Gao Suying;Wang Yongjun;Ji Ruiye;Xu Lihua;Liu Xuan;Geng Song;Wang Hongtao;Qin Shangmin(College of Basic Medicine,Hebei Medical University,Shijiazhuang 050017,China;Department of Neurology,Kangjixintu Hospital,Renqiu 062550,China;Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Department of Ultrasound,General Hospital of Jizhong Energy Fengfeng Group Co.,Ltd,Handan 056000,China)

机构地区：[1]河北医科大学基础医学院,石家庄050017 [2]任丘康济新图医院神经内科,任丘062550 [3]首都医科大学附属北京天坛医院神经病学中心,北京100070 [4]冀中能源峰峰集团有限公司总医院超声科,邯郸056000

出　　处：《中国医师进修杂志》2022年第11期961-967,共7页Chinese Journal of Postgraduates of Medicine

基　　金：2021年度河北省医学科学研究课题计划(20210705)。

摘　　要：目的探讨代谢综合征与老年急性脑梗死(ACI)患者1年结局不良的关系。方法选择任丘康济新图医院2014年1月至2018年11月连续收治的老年ACI患者的临床资料,分为代谢综合征组(931例)和非代谢综合征组(1851例)。比较两组老年ACI患者的临床资料,采用多因素Logistic回归分析代谢综合征对老年ACI 1年结局不良[改良Rankin量表(mRS)>2分]的影响。结果代谢综合征组女性、高血压、糖尿病、高脂血症、冠心病、吸烟、过量饮酒、抗血小板药物使用的比例高于非代谢综合征组[52.74%(491/931)比32.58%(603/1851)、79.16%(737/931)比64.29%(1190/1851)、42.32%(394/931)比6.43%(119/1851)、17.19%(160/931)比11.62%(215/1851)、18.90%(176/931)比14.10%(261/1851)、62.73%(584/931)比50.89%(942/1851)、3.73%(69/931)比1.61%(15/1851)、19.23%(179/931)比15.51%(287/1851)],体质量指数、收缩压、舒张压、空腹血糖(FPG)、三酰甘油(TG)、总胆固醇(TC)、血小板计数(PLT)、纤维蛋白原(FIB)、跌倒评分水平高于非代谢综合征组[26.67(25.31,28.60)kg/m^(2)比23.30(21.48,24.91)kg/m^(2)、(167.17±22.96)mmHg(1 mmHg=0.133 kPa)比(164.21±24.90)mmHg、(87.06±13.10)mmHg比(85.76±12.99)mmHg、(7.33±2.64)mmol/L比(5.35±1.38)mmol/L、(2.12±1.51)mmol/L比(1.13±0.78)mmol/L、(4.97±1.31)mmol/L比(4.65±0.99)mmol/L、213.00(179.00,256.00)×10^(9)/L比203.00(172.00,241.00)×10^(9)/L、3.07(2.63,3.52)g/L比2.94(2.55,3.37)g/L、(6.12±1.70)分比(5.93±1.74)分],而年龄、高密度脂蛋白胆固醇(HDL-C)、同型半胱氨酸(Hcy)、压疮评分水平低于非代谢综合征组[(69.29±6.96)岁比(71.28±7.66)岁、(0.98±0.34)mmol/L比(1.31±0.88)mmol/L、(18.93±13.07)mmol/L比(21.66±16.39)mmol/L、(18.55±2.42)分比(19.02±2.43)分],差异均有统计学意义(P<0.05)。随访1年,代谢综合征组结局不良比例高于非代谢综合征组[21.70%(202/931)比18.69%(346/1851)],差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄[OR(95%CI)=1.056(1.0Objective To investigate the relationship between metabolic syndrome and 1-year poor outcome in elderly patients with acute cerebral infarction(ACI).Methods The clinical data of elderly patients with ACI admitted to Renqiu Kangjixintu Hospital from January 2014 to November 2018 were selected and divided into metabolic syndrome group(931 cases)and non-metabolic syndrome group(1851 cases).The clinical data of the two groups of elderly patients with ACI were compared,and the effect of metabolic syndrome on poor outcome(modified Rankin scale>2 scores)of elderly patients with ACI in 1 year was analyzed by multivariate Logistic regression.Results The proportion of female,hypertension,diabetes,hyperlipidemia,coronary heart disease,smoking,excessive alcohol consumption and antiplatelet drug use in the metabolic syndrome group were higher than those in the non-metabolic syndrome group:52.74%(491/931)vs.32.58%(603/1851),79.16%(737/931)vs.64.29%(1190/1851),42.32%(394/931)vs.6.43%(119/1851),17.19%(160/931)vs.11.62%(215/1851),18.90%(176/931)vs.14.10%(261/1851),62.73%(584/931)vs.50.89%(942/1851),3.73%(69/931)vs.1.61%(15/1851),19.23%(179/931)vs.15.51%(287/1851),the levels of body mass index,systolic blood pressure,diastolic blood pressure,fasting plasma glucose(FPG),fasting plasma glucose(TG),total cholesterol(TC),platelet(PLT),fibrinogen(FIB),fall score were higher than those in non-metabolic syndrome group:26.67(25.31,28.60)kg/m^(2) vs.23.30(21.48,24.91)kg/m^(2),(167.17±22.96)mmHg(1 mmHg=0.133 kPa)vs.(164.21±24.90)mmHg,(87.06±13.10)mmHg vs.(85.76±12.99)mmHg,(7.33±2.64)mmol/L vs.(5.35±1.38)mmol/L,(2.12±1.51)mmol/L vs.(1.13±0.78)mmol/L,(4.97±1.31)mmol/L vs.(4.65±0.99)mmol/L,213.00(179.00,256.00)×10^(9)/L vs.203.00(172.00,241.00)×10^(9)/L,3.07(2.63,3.52)g/L vs.2.94(2.55,3.37)g/L,(6.12±1.70)scores vs.(5.93±1.74)scores,the levels of age,high density lipoprotein cholesterol(HDL-C),homocysteine(Hcy)and pressure ulcer score were lower than those of non-metabolic syndrome group:(69.29±6.96)years vs.(71.28±7.66)years,(0

关 键 词：代谢综合征 大脑梗塞 脑梗死 结局不良 危险因素 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R589[医药卫生—临床医学]