代谢综合征合并脑卒中与颈动脉粥样硬化的关系(1)
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[摘要] 目的：探讨代谢综合征合并脑卒中与颈动脉粥样硬化的关系。方法：选取门诊的代谢综合征(MS)合并脑卒中患者50例，单纯脑卒中患者48例，健康患者50例。对其进行病史询问，测量代谢相关指标，静脉血检测血糖、三酰甘油、胆固醇等，并对所有入选者进行颈动脉血管多普勒超声检查，测量颈动脉内膜中层厚度(IMT)、收缩期血流峰值、阻力指数及斑块数量，对两组检测结果进行比较，并分析MS合并脑卒中、IMT与颈动脉粥样硬化之间的关系。结果：MS合并脑卒中组在体重指数、腰臀比、收缩压、舒张压及冠心病患病率均高于对照组(P<0.05)；MS合并脑卒中组颈动脉IMT及斑块数量明显高于单纯脑卒中组(P<0.05)；多因素Logistic回归分析显示，年龄、MS合并脑卒中、IMT、SBP与颈动脉内膜厚度呈正相关(P<0.05)。结论：代谢综合征合并脑卒中与颈动脉粥样硬化超声改变存在相关性。
[关键词] 代谢综合征；脑卒中；冠心病；颈动脉；粥样硬化
[中图分类号] R543 [文献标识码] B [文章编号] 1673-7210(2011)12(b)-189-03
Relationship between Carotid artery atherosclerosis and MS with stroke
LI Li
The Outpatient Department, the People's Daily News Agency, Beijing 100026, China
[Abstract] Objective: To investigate the relation between carotid artery atherosclerosis and metabolic syndrome (MS) with stroke. Methods: 50 patients of MS with stroke, 48 patients with MS and 40 healthy people were selected. Metabolic index including body mass index, waist-hip ratio, blood pressure of three groups were recorded. Blood sample was taken to detect blood sugar, triglyceride, cholesterol. The relationship of carotid intima-media thickness (IMT) and atherosclerotic plaques in the MS with stroke group was detected and measured. Results: Waist-hip ratio, body mass index, systolic pressure, diastolic pressure and the rate of coronary disease in MS with stroke group were higher than that of control group (P<0.05); logistic analysis suggested that age, MS with stroke, systolic blood pressure were related to IMT (P<0.05). Conclusion: The changes of carotid IMT were related to MS with stroke more than stroke.
[Key words] Metabolic syndrome; Stroke; Carotid atherosclerosis
代谢综合征(metabolic syndrome，MS)又称胰岛素抵抗代谢综合征(insulin resistance metabolic syndrome，IRMS)，是由于胰岛素抵抗引起的一系列临床、生化、体液代谢失常，从而导致物质代谢失常的综合征，常包括肥胖、高血压、高血糖、胰岛素抵抗、血脂异常等。
近年来研究发现MS人群发生心脑血管病的机率明显高于正常人群[1]，说明MS与动脉粥样硬化性疾病的联系日益明确，同时，颈动脉粥样硬化是全身动脉硬化的重要组成成分，也是心脑血管疾病的常见原因之一。笔者通过彩色多普勒超声检查颈动脉结构，进一步探讨MS、颈动脉结构与脑血管病之间的关系。
1 资料与方法
1.1 一般资料
选取2006年12月~2007年9月在我门诊就诊的患者及健康查体人群共148例。将其分为MS合并脑卒中组50例，脑卒中组48例，健康对照组50例。MS的诊断根据中华糖尿病学会2004年诊断标准：①体重指数(BMI)≥25.0；②空腹血糖≥6.1 mmol/L，及(或)餐后2 h血糖≥7.8 mmol/L，或已诊断为糖尿病并治疗者；③收缩压(SBP)/舒张压(DBP)≥140/90 mm Hg(1 mm Hg=0 ......
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