[1]贺大权 温宏峰 金迪 张斌如 赵静 徐亚辉 王培福.糖尿病合并短暂性脑缺血发作患者发展为脑梗死的独立预测因素[J].卒中与神经疾病杂志,2019,26(01):68-72.[doi:10.3969/j.issn.1007-0478.2019.01.016]
　He Daquan,Wen Hongfeng,Jin Di,et al.The independent predictors of stroke developing from transient ischemic attack among patients with diabetes mellitus[J].Stroke and Nervous Diseases,2019,26(01):68-72.[doi:10.3969/j.issn.1007-0478.2019.01.016]
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糖尿病合并短暂性脑缺血发作患者发展为脑梗死的独立预测因素()
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《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第26卷
期数:
2019年01期
页码:
68-72
栏目:
论 著
出版日期:
2019-02-26

文章信息/Info

Title:
The independent predictors of stroke developing from transient ischemic attack among patients with diabetes mellitus
文章编号:
1007-0478(2019)01-0068-05
作者:
贺大权 温宏峰 金迪 张斌如 赵静 徐亚辉 王培福
100049 北京,航天中心医院(北京大学航天临床医学院)神经内科[贺大权 温宏峰 金迪 赵静 徐亚辉 王培福(通信作者)]; 河北易县医院内三科(张斌如)
Author(s):
He Daquan; Wen Hongfeng;  Jin Di; et al
Department of Neurology,Peking University Aerospace School of Clinical Medicine,Beijing 100049
关键词:
血管延长扩张 糖化血红蛋白 缺血性脑卒中 短暂性脑缺血发作
Keywords:
Dolichoectasia Glycated hemoglobin Iischemic stroke Transient ischemic attack
分类号:
R743.31
DOI:
10.3969/j.issn.1007-0478.2019.01.016
文献标志码:
A
摘要:
目的 评估糖尿病合并短暂性脑缺血发作患者发展为脑梗死的独立预测因素。方法 入选2013年1月-2015年6月就诊于航天中心医院卒中中心的短暂性脑缺血发作合并糖尿病的患者,收集临床资料(常规、生化、凝血功能、糖化血红蛋白、心脏超声),行核磁共振造影检查,并随访30个月,记录脑梗死事件和较差的功能结局(改良的Rankin量表2～6分)。结果 最终235例患者入选,其中有70例(29.8%)在随访期内发生脑梗死,59例患者被发现Rankin量表达到2～6分,14例患者6月内发生脑梗死,cox多因素回归分析发现,基底动脉动脉延长扩张和高龄是30个月内发生脑梗死的独立预测因素。基底动脉延长扩张能够独立预测随访期内2～6分的改良Rankin量表评分。基底动脉动脉延长扩张和高水平糖化血红蛋白能够预测6个月内脑梗死的发生,而且生存曲线提示基底动脉延长扩张者6个月内及30个月内发展为脑梗死风险明显高于其余患者,糖化血红蛋白水平高于中位数者(6.2%)6个月内发展为脑梗死风险明显高于糖化血红蛋白水平相对低的患者。结论 血管畸形和血糖控制差的患者容易由短暂性脑缺血发作进展为脑梗死,远期生活质量也受到影响。
Abstract:
ObjectiveTo estimate the independent predictors of stroke developing from transient ischemic attack among patients with diabetes mellitus.Methods Patients with transient ischemic attack and diabetes mellitus were enrolled into our study from the January 2013 to June 2015 in our center, clinical data including blood routine, biochemical parameters,coagulation function, glycated hemoglobin were accessed, echocardiography and magnetic resonance angiography were processed before 30-month follow-up, ischemic stroke events and poor functional outcome(modified Rankin scale 2～6)were recorded during the period of follow-up.Results Overall 235 patients were enrolled in our research. A total of 70(29.8%)patients suffered incidence of ischemic stroke, while 59 patients were found with poor functional outcome(modified Rankin scale 2～6). Multivariable cox regression analysis showed dolichoectasia in basilar artery bifurcation and elderly were independent predictors of ischemic stroke within 30 months. Dolichoectasia could predict 2～6 points of modified Rankin scale independently. Higher level of glycated hemoglobin and dolichoectasia could predict ischemic stroke within 6 months. Furthermore, Kaplan-meier curve indicated that patients with dolichoectasia in basilar artery bifurcation and glycated hemoglobin above median of 6.2% suffered higher risk of developing ischemic stroke within 6 months than others. While patients with dolichoectasia in basilar artery bifurcation also suffered higher risk of ischemic stroke within 30 months.Conclusion Intracranial vascular malformation and poor glycemic control were liable to develop into ischemic stroke from transient ischemic attack and suffer poor life quality in long term.

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备注/Memo

备注/Memo:
作者单位:100049 北京,航天中心医院(北京大学航天临床医学院)神经内科[贺大权 温宏峰 金迪 赵静 徐亚辉 王培福(通信作者)]; 河北易县医院内三科(张斌如)
更新日期/Last Update: 2019-02-20