摘要
目的分析代谢综合征(metabolic syndrome,MS)和/或糖尿病(diabetes mellitus,DM)对大动脉粥样硬化型(large artery atherosclerosis,LAA)急性缺血性脑卒中患者出院和3个月预后的影响。方法对2016年4月~2019年7月于哈尔滨医科大学附属第一医院神经内科卒中病房入院的871例LAA亚型急性缺血性脑卒中患者进行了前瞻性调查。根据代谢综合征和糖尿病的状态,将LAA亚型患者分为既无代谢综合征也无糖尿病(MS-,DM-)、仅有代谢综合征(MS+,DM-)、仅有糖尿病(MS-,DM+),以及同时存在代谢综合征和糖尿病(MS+,DM+)4组。使用Logistic回归模型评估代谢综合征和/或糖尿病对LAA亚型患者出院及3个月预后的影响。结果对于出院结局,仅有代谢综合征和仅有糖尿病与LAA亚型患者出院不良预后无关,调整后的OR(95%CI)分别为1.284(0.835,1.974)、1.650(0.998,2.727)。同时存在代谢综合征和糖尿病与LAA亚型患者出院不良的预后风险增加有关,调整后的OR(95%CI)为2.435(1.464,4.050)。对于3个月结局,仅有代谢综合征和仅有糖尿病与LAA亚型患者3个月预后无关,调整后的OR(95%CI)分别为1.439(0.837,2.473)、1.842(0.986,3.440)。同时存在代谢综合征和糖尿病与LAA亚型患者3个月不良预后风险增加有关,调整后的OR(95%CI)为2.083(1.117,3.885)。结论同时存在代谢综合征和糖尿病增加了LAA亚型患者出院和3个月不良预后风险。
Objective To analyze the effects of metabolic syndrome(MS)and/or diabetes mellitus(DM)on discharge and 3-month prognosis of patients with large aortic atherosclerosis(LAA)type of acute ischemic stroke.Methods A prospective study of 871 patients with LAA acute ischemic stroke admitted to the Department of Neurology,the Affiliated Hospital of Harbin Medical University from April 2016 to July 2019.According to the status of metabolic syndrome and diabetes,patients with LAA acute ischemic stroke were divided into 4 groups of neither MS nor DM(MS^-,DM^-),only MS(MS^+,DM^-),only DM(MS^-,DM^+),and coexistence of MS and DM(MS^+,DM^+).Logistic regression model was used to assess the effect of metabolic syndrome and/or diabetes on discharge and 3-month prognosis of patients with LAA.Results For discharge outcomes,only MS and only DM were not associated with poor prognosis for patients with LAA.The adjusted ORs(95%CI)were 1.284(0.835,1.974)and 1.650(0.998,2.727),respectively.The simultaneous presence of MS and DM was associated with an increased risk of poor discharge outcomes for patients with LAA subtype.The adjusted OR(95%CI)was 2.435(1.464,4.050).For 3-month outcomes,only MS and only DM were not associated with the 3-month prognosis of patients with LAA subtype.The adjusted ORs(95%CI)were 1.439(0.837,2.473)and 1.842(0.986,3.440),respectively.The coexistence of MS and DM was associated with an increased 3-month adverse prognosis risk in patients with LAA subtype,and the adjusted OR(95%CI)was 2.083(1.117,3.885).Conclusion Both MS and DM increase the poor prognosis risk of discharge and 3-month for patients with LAA subtype.
作者
刘新遥
汤颖
耿旭洋
冯安琪
王嘉敏
刘悦
谢昊
许佳
赵景波
LIU Xin-yao;TANG Ying;GENG Xu-yang;FENG An-qi;WANG Jia-min;LIU Yue;XIE Hao;XU Jia;ZHAO Jing-bo(Department of Epidemiology,School of Public Health,Harbin Medical University,Harbin 150081,China;Department of Emergency Neurology,The First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)
出处
《哈尔滨医科大学学报》
CAS
2020年第1期54-58,共5页
Journal of Harbin Medical University
基金
黑龙江省自然科学基金资助项目(D201235)
关键词
急性缺血性脑卒中
代谢综合征
糖尿病
出院预后
3个月预后
acute ischemic stroke
metabolic syndrome
diabetes mellitus
discharge prognosis
3-month prognosis
