【摘要】：目的:分析2型糖尿病患者缺血性腦血管疾病的流行狀況和分布特點,并探索2型糖尿病患者中陳舊性腦梗塞和慢性腦供血不足的相關因素,為糖尿病患者缺血性腦血管疾病的防治提供科學研究依據(jù)。方法:回顧性查閱2008年1月1日至2013年3月1日天津醫(yī)科大學代謝病醫(yī)院住院的2型糖尿病患者(2525例)的病歷資料,摘錄相關信息,選取其中有明確腦血管疾病史和本次住院進行過CT或MRI檢查的2型糖尿病患者共2169例作為本次的研究對象,分析2型糖尿病患者陳舊性腦梗死及慢性腦供血不足的患病情況和分布特點;分別選取其中陳舊性腦梗死的2型糖尿病患者178例、慢性腦供血不足的2型糖尿病患者388例作為病例組,無腦血管病的2型糖尿病患者1372例作為對照組,采用非條件Logistic回歸模型分析陳舊性腦梗死及慢性腦供血不足的相關因素,計算比值比(OR)及其95%可信區(qū)間(95%CI)。結果:1、在2169例2型糖尿病住院患者中,797例有腦血管疾病,患病率為36.7%,包括陳舊性腦梗塞178例,患病率為8.2%,慢性腦供血不足388例,患病率為17.9%;1372例2型糖尿病患者無腦血管疾病。陳舊性腦梗塞和慢性腦供血不足患者的患病率均隨著2型糖尿病患者年齡和病程的增加而增加。2、陳舊性腦梗塞組平均年齡、SBP、血尿酸水平及周圍神經(jīng)病變、高血壓、冠心病、糖尿病足、高纖維蛋白原血癥的患病率高于無腦血管疾病組。慢性腦供血不足組的平均年齡及骨質疏松患病率高于無腦血管疾病組。差異具有統(tǒng)計學意義。陳舊性腦梗塞組及腦供血不足組的Hb A1c水平均低于無腦血管疾病組,差異具有統(tǒng)計學意義。3、單因素Logistic回歸分析結果顯示:高齡、男性、糖尿病病程長、合并周圍神經(jīng)病變、高血壓、冠心病、糖尿病足、高纖維蛋白血癥、骨質疏松、高血壓家族史、BMI(29)24kg/m2與2型糖尿病中陳舊性腦梗塞高風險有統(tǒng)計學關聯(lián)。高齡、糖尿病病程長、周圍神經(jīng)病變、高血壓、冠心病、高纖維蛋白血癥及骨質疏松與2型糖尿病中慢性腦供血不足的高風險有統(tǒng)計學關聯(lián)。對上述單因素Logistic分析有統(tǒng)計學關聯(lián)的變量,采用前進法進行多因素Logistic回歸分析,結果顯示高齡、男性、糖尿病病程長、BMI(29)24kg/m2及有高血壓疾病史與2型糖尿病中陳舊性腦梗塞的高風險有關。年齡大、合并骨質疏松與2型糖尿病中慢性腦供血不足的高風險有關。結論:2型糖尿病患者中缺血性腦血管疾病的患病率較高。陳舊性腦梗塞和慢性腦供血不足的患病率均隨2型糖尿病患者年齡和病程的增加而增加。2型糖尿病患者的年齡、性別以及相關疾病可能與陳舊性腦梗塞和慢性腦供血不足有關。
[Abstract]:Objective: to analyze the prevalence and distribution of ischemic cerebrovascular diseases in patients with type 2 diabetes, and to explore the related factors of old cerebral infarction and chronic cerebral insufficiency in patients with type 2 diabetes. To provide scientific basis for the prevention and treatment of ischemic cerebrovascular disease in diabetic patients. Methods: from January 1, 2008 to March 1, 2013, the medical records of 2525 patients with type 2 diabetes mellitus in the metabolic disease hospital of Tianjin Medical University were reviewed and the relevant information was extracted. A total of 2169 patients with type 2 diabetes mellitus who had a definite history of cerebrovascular disease and had been examined by CT or MRI in this hospital were selected as the subjects of this study. To analyze the prevalence and distribution of old cerebral infarction and chronic cerebral insufficiency in patients with type 2 diabetes mellitus, 178 cases of type 2 diabetes mellitus with old cerebral infarction were selected. There were 388 cases of type 2 diabetes with chronic cerebral insufficiency and 1372 cases of type 2 diabetes without cerebrovascular disease as control group. The factors related to old cerebral infarction and chronic cerebral insufficiency were analyzed by non-conditional logistic regression model. Calculate the ratio (OR) and its 95% confidence interval (95 CI). Results among 2169 hospitalized patients with type 2 diabetes, 797 had cerebrovascular disease, the prevalence rate was 36.7, including 178 cases of old cerebral infarction, the prevalence rate was 8.2 and 388 cases of chronic cerebral blood supply insufficiency. The prevalence rate was 17.9% and 1372 cases of type 2 diabetes without cerebrovascular disease. The prevalence of old cerebral infarction and chronic cerebral insufficiency increased with the increase of age and course of disease in type 2 diabetes mellitus. The mean age of patients with old cerebral infarction was SBP, serum uric acid level, peripheral neuropathy, hypertension, coronary heart disease. The prevalence of diabetic foot and hyperfibrinogenemia was higher than that of non-cerebrovascular disease group. The average age and the prevalence of osteoporosis in chronic cerebral insufficiency group were higher than those without cerebrovascular disease group. The difference is statistically significant. The levels of HB A1c in the old cerebral infarction group and the cerebral blood supply insufficiency group were lower than those in the non-cerebrovascular disease group, the difference was statistically significant. The results of univariate logistic regression analysis showed that the age, male, long course of diabetes, and peripheral neuropathy were the same as those in the old cerebral infarction group and the cerebral blood supply insufficiency group. Hypertension, coronary heart disease, diabetic foot, hyperfibrinemia, osteoporosis, family history of hypertension, BMI _ (29) 24kg/m2 were significantly associated with the high risk of old cerebral infarction in type 2 diabetes. Advanced age, long course of diabetes, peripheral neuropathy, hypertension, coronary heart disease, hyperfibrinemia and osteoporosis were associated with high risk of chronic cerebral insufficiency in type 2 diabetes. Multivariate logistic regression analysis was carried out for the variables with statistical correlation in the single factor logistic analysis. The results showed that the elderly, male, and male, were analyzed by multivariate logistic regression analysis. 24kg/m2 and history of hypertension were associated with high risk of old cerebral infarction in type 2 diabetes. Older patients with osteoporosis are associated with a high risk of chronic cerebral insufficiency in type 2 diabetes. Conclusion the prevalence of ischemic cerebrovascular disease is higher in type 2 diabetes mellitus. The prevalence of old cerebral infarction and chronic cerebral insufficiency increased with the increase of age and course of disease in type 2 diabetes mellitus. The age, sex and related diseases of type 2 diabetes mellitus patients may be related to old cerebral infarction and chronic cerebral insufficiency.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R743;R587.2

【參考文獻】

相關期刊論文 前10條

1 王慧卿;王桂英;楊德兵;尉杰忠;;2型糖尿病合并腦梗塞的危險因素分析[J];山西大同大學學報(自然科學版);2016年02期

2 宋紹敏;姚濤;董巖;周劍輝;李占杰;陸昆;阮曉蘭;張曉輝;孫靜;吳壽嶺;金成;王志彬;;糖尿病人群中各型高血壓的分布情況及其影響因素研究[J];中國全科醫(yī)學;2015年07期

3 張興凱;馮菁;郭玉州;侯曉平;付金喜;張作鵬;;冠狀動脈病變與頸動脈粥樣硬化相關性研究[J];河北醫(yī)學;2012年01期

4 喻文雅;閆玉英;姜彩肖;;石家莊市腦卒中流行病學特征及危險因素的Logistic分析[J];河北醫(yī)藥;2010年17期

5 傅新民;陳興國;劉春燕;黃亞軍;王自正;徐運;;hs-CRP水平與腦卒中腦損傷程度的相關性[J];放射免疫學雜志;2009年06期

6 李旭雯;宋宏中;謝正;;老年人頸動脈粥樣硬化與腦梗死關系的臨床分析[J];中國醫(yī)療前沿;2009年12期

7 李志平;謝向東;姜穩(wěn)妮;;糖尿病性腦梗死對比分析[J];中國實用神經(jīng)疾病雜志;2009年03期

8 孫兆青;鄭黎強;張大義;祝榮才;張新忠;張新剛;劉雙雙;許長祿;李佳進;趙芬芬;李覺;胡大一;孫英賢;;遼寧省農(nóng)村人群腦卒中的流行病學特征及危險因素調查[J];中國現(xiàn)代醫(yī)學雜志;2008年06期

9 劉學東;王波;劉雅;趙鋼;吳中亮;劉之榮;呂亞麗;徐德忠;;缺血性卒中功能預后及其影響因素的回顧性研究[J];疾病控制雜志;2008年01期

10 李建平;霍勇;劉平;秦獻輝;關德明;葛均波;胡健;王燕妮;張馥敏;毛廣運;徐希平;;馬來酸依那普利葉酸片降壓、降同型半胱氨酸的療效和安全性[J];北京大學學報(醫(yī)學版);2007年06期

相關會議論文 前1條

1 張曉明;管竹飛;王彥梅;劉銘;郭景春;董強;周厚廣;;糖尿病性腦血管病的研究新進展[A];中華醫(yī)學峰會暨中華醫(yī)學會神經(jīng)病學分會第八屆全國中青年神經(jīng)病學學術會議論文匯編[C];2015年

相關博士學位論文 前1條

1 汪桂艷;蒙古族人群腦卒中危險因素的隊列研究[D];蘇州大學;2013年

相關碩士學位論文 前3條

1 郝攀;血清超敏CRP及尿酸與2型糖尿病合并腦梗塞的臨床研究[D];蘭州大學;2014年

2 謝炎蓉;2型糖尿病合并腦梗塞的危險因素及中醫(yī)證候回顧性調查研究[D];山東中醫(yī)藥大學;2012年

3 孫強;慢性腦供血不足患者認知功能障礙及其危險因素研究[D];吉林大學;2010年

，

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