本文選題：急性腦梗死 + 2型糖尿病　； 參考：《蘭州大學(xué)》2017年碩士論文

【摘要】：目的:對急性腦梗死合并2型糖尿病患者進行中國缺血性卒中亞型(China Ischemic Stroke Subclassification,CISS)分型,統(tǒng)計各亞型病因分型構(gòu)成比以及不同的危險因素對各病因分型的影響;探討總膽固醇水平與急性腦梗死合并2型糖尿病的相關(guān)性。方法:選擇收入我院神經(jīng)內(nèi)科(2014年4月至2016年4月)發(fā)病72小時內(nèi)且合并2型糖尿病的急性腦梗死患者376例,并進行CISS分型,單純急性腦梗死292例,健康體檢者389例,常規(guī)抽取空腹靜脈血,檢測包括尿酸、血同型半胱氨酸以及纖維蛋白原和血脂等在內(nèi)的生化指標,并分析其與急性腦梗死合并2型糖尿病患者CISS分型的相關(guān)性。結(jié)果:急性腦梗死合并2型糖尿病患者的CISS分型中,大動脈粥樣硬化性卒中(Large Artery Atherosclerosis,LAA)一共有191例(50.70%),病因不確定(Undetermined Etiology,UE)數(shù)量為103例(27.60%),其次分別為穿支動脈疾病(Penetrating Artery Disease,PAD)51例(13.50%),心源性腦卒中(Cardiogenic Stroke,CS)30例(8.00%)、其他原因所致缺血性卒中(Other Etiology,OE)1例(1.00%)。年齡、TG、LDL是LAA型的危險因素。CS的TC水平均低于其他4類亞型(P0.05),其余亞型兩兩比較無差異(P0.05),存在“膽固醇悖論”現(xiàn)象。年齡是CS型的危險因素。TC是PAD型的危險因素,PAD型高血壓合并比例最高。飲酒是UE型的危險因素。TC水平降低與單純腦梗死和急性腦梗塞合并2型糖尿病發(fā)病具有顯著相關(guān)性。結(jié)論:急性腦梗死合并2型糖尿病患者中以LAA及UE為主;不同類型缺血性腦卒中與不同危險因素有關(guān),LDL是LAA的危險因素,冠心病是CS的危險因素,飲酒是UE的危險因素;心源性腦卒中存在“膽固醇悖論”現(xiàn)象;急性腦梗死合并2型糖尿病患者存在“膽固醇悖論”現(xiàn)象。
[Abstract]:Objective: to classify the patients with acute cerebral infarction complicated with type 2 diabetes mellitus by China Ischemic Stroke subclassification CISS, and to calculate the proportion of the etiological classification of each subtype and the influence of different risk factors on the etiological classification.To investigate the correlation between total cholesterol level and type 2 diabetes mellitus with acute cerebral infarction.Methods: 376 patients with acute cerebral infarction within 72 hours of onset and complicated with type 2 diabetes were selected from neurology department of our hospital (from April 2014 to April 2016). CISS classification was performed in 292 patients with simple acute cerebral infarction and 389 healthy controls.Fasting venous blood was collected routinely to detect the biochemical indexes including uric acid, homocysteine, fibrinogen and blood lipids, and to analyze their correlation with CISS typing in patients with acute cerebral infarction and type 2 diabetes mellitus.Results: in the CISS classification of patients with acute cerebral infarction and type 2 diabetes,The level of TC in age group was lower than that in other four subtypes (P 0.05), but there was no difference in other subtypes (P 0.05), and there was a phenomenon of "cholesterol paradox".Age is the risk factor of CS type. TC is the risk factor of PAD type.Alcohol consumption was a risk factor of UE type. TC level decreased significantly with simple cerebral infarction and acute cerebral infarction with type 2 diabetes.Conclusion: LAA and UE are the main risk factors in patients with acute cerebral infarction and type 2 diabetes, and different types of ischemic stroke are associated with different risk factors. Coronary heart disease is the risk factor of CS, alcohol consumption is the risk factor of UE.There is "cholesterol paradox" in cardiogenic stroke and "cholesterol paradox" in patients with acute cerebral infarction and type 2 diabetes mellitus.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R743.3;R587.1

【參考文獻】

相關(guān)期刊論文 前6條

1 ;腦卒中篩查與防治技術(shù)規(guī)范[J];中國醫(yī)學(xué)前沿雜志(電子版);2013年09期

2 譚麗艷;宋永斌;焦巖;鄭俊;楊俊;徐江濤;;急性缺血性腦卒中CISS分型與危險因素相關(guān)性分析[J];中華腦血管病雜志(電子版);2013年02期

3 中華醫(yī)學(xué)會神經(jīng)病學(xué)分會腦血管病學(xué)組急性缺血性腦卒中診治指南撰寫組;;中國急性缺血性腦卒中診治指南2010[J];中國全科醫(yī)學(xué);2011年35期

4 李曉蕾;李菁晶;李軼;王擁軍;;缺血性卒中A—S—C—O分型、TOAST分型及CISS分型的信度檢驗[J];中國卒中雜志;2011年05期

5 耿延磊;滕繼軍;;TOAST分型中不明原因型腦梗死相關(guān)危險因素的研究[J];中華腦血管病雜志(電子版);2011年01期

6 趙鐵梅,劉晶翠;糖尿病足治療前后微循環(huán)與血液流變學(xué)變化[J];吉林醫(yī)學(xué);2005年10期

相關(guān)博士學(xué)位論文 前1條

1 王會娟;2型糖尿病患者膽固醇外流的功能改變及機制研究[D];中國協(xié)和醫(yī)科大學(xué);2009年

相關(guān)碩士學(xué)位論文 前1條

1 蔡霞;基于CISS分型的缺血性卒中危險因素及臨床特點的分析[D];山西醫(yī)科大學(xué);2011年

，

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