摘要
目的 研究代谢综合征 (metabolicsyndrome ,MS)与所包含的心脑血管危险因子高血压病 (essentialhyperten sion ,EH)、糖尿病 (diabetesmellitus ,DM)和脂质代谢紊乱对急性脑血管病 (acutecerebrovasculardisease ,ACVD)亚型的影响。方法 5 0 2例ACVD住院患者为病例组 ,包括脑出血 (intracerebralhemorrhage ,ICH) 12 1例和脑梗死 (cerebralinfarct ,CI) 3 81例。无脑血管者 40 1例为对照组 ,分析MS、EH、DM和血脂对ACVD亚型的影响。结果 ACVD各亚型伴EH率明显高于对照组 (P <0 0 1) ,ICH组又明显高于全部缺血组 (P <0 0 1) ;各组伴DM率亦显著高于对照组 (P <0 0 1) ,ICH组则明显低于缺血组 (P <0 0 1) ;各组伴MS率也明显高于对照组 (P <0 0 1) ,但组间无显著性差异 (P >0 0 5 ) ;缺血组血清胆固醇浓度显著低于对照组 (P <0 0 5 ) ,CI和腔隙性梗死组血甘油三酯含量明显高于对照组 (P <0 0 5 )。EH使ACVD全部亚型的危险性增高 (OR =4 95～ 2 4 0 4,P <0 0 5 ) ,OR值以ICH组最大。DM使缺血性卒中亚型的危险性明显增高 (OR =4 2 5～4 76,P <0 0 1)。总胆固醇则除脑血栓形成组外 ,OR值均小于 1。甘油三酯仅腔隙性脑梗死组OR值为 1 2 2 (P <0 0 5 )。MS使出血和缺血亚型的危险性明显增加 (OR
Objective To investigate the effects of metabolic syndrome (MS) and the cardiocerebrovascular risk factors such as essential hypertension (EH), diabetes mellitus (DM), and lipid metabolise disturbance on the subtypes of acute cerebrovascular disease (ACVD). Methods A total of 502 ACVD patients were studied, including 121 cases of intracerebral hemorrhage (ICH) and 381 cases of cerebral infarct (CI). The effects of MS, EH, DM, and blood lipids on the subtypes of ACVD were analyzed. Results The ratio of all subtypes of ACVD combined with EH was significantly higher than that of the control group ( P <0.01). The ratio of ICH group combined with EH was significantly higher than that of all ischemic groups ( P <0.01). The ratio of all subtypes of ACVD combined with DM was significantly higher than that of the control group, too ( P <0.01). The ratio of ICH group combined with DM was obviously lower than that of the ischemic group ( P <0.01). The ratio of each group combined with MS was also significantly higher than that of the control group ( P <0.01), but there was not significant difference between the groups ( P >0.05). Additionally, the concentration of total cholesterol in the ischemic group was significantly lower than that in the control group ( P <0.05), and the concentrations of triglycerides in CI and lacunar infarct (LI) groups were also obviously higher than those in the control group ( P <0.05). EH was associated with higher risk of all subtypes of ACVD ( OR =4.95-24.04, P <0.05). Highest OR was found in ICH group. DM was associated with higher risk in ischemic groups ( OR =4.25-4.76, P <0.01). OR of total cholesterol was <1 except in cerebral thrombosis (CT) group. Triglycerides were associated with higher risk of LI ( OR =1.22, P <0.05). MS was associated with higher risk of all subtypes of ACVD ( OR =2.51-7.31, P <0.05). Conclusion MS and EH are positively associated with all ACVD subtypes. However, EH may be associated with ICH and MS which participate in the cerebral thrombosis. Effects of MS on the onset of subtypes of ACVD are dependent on the risk factors included in MS. DM is positively associated with ischemic stroke. The concentration of total cholesterol is negatively associated with ischemic stroke.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2004年第17期1545-1548,共4页
Journal of Third Military Medical University
关键词
脑卒中
代谢综合征
高血压病
糖尿病
胆固醇
甘油三酯
cerebrovascular disease
metabolic syndrome
essential hypertension
diabetes mellitus
cholesterol
triglyceride
