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目的评估多梗死性痴呆(MID)患者与代谢综合征(Mets)之间的关系。方法 85例神经内科住院治疗的反复发生2次以上脑梗死患者,将所有患者分为伴代谢综合征组(Mets组,39例)与不伴代谢综合征组(NMets组,46例)。所有患者均于入院时、第1个月及第6个月进行痴呆及神经功能缺损评分,并在空腹状态测量所有研究对象的腰围、血压,静脉血检测血脂相关指标、空腹血糖(FPG)、餐后2 h血糖、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS),采用稳态模型(HOMA)方法评估胰岛素抵抗(IR)=FINS×FPG/22.5,必要时行口服葡萄糖耐量试验(OGTT)。结果 Mets组入院时、第1个月、第6个月多梗死痴呆发生率分别为59.0%、64.1%、61.5%,NMets组分别为32.6%、34.8%、34.8%。两组患者在入院时、第1个月、第6个月出现多梗死痴呆情况比较差异具有统计学意义(P<0.05);Mets组发生痴呆的严重程度较NMets组明显增加,其中,在发病的第1个月内,发生血管性痴呆的风险明显增高(P<0.05)。结论代谢综合征使多发脑梗死患者发生多梗死性痴呆的风险明显增高;对于伴有代谢综合征的多发脑梗死患者,发病第1个月发生血管性痴呆的风险最高;对于早期出现血管性痴呆患者,合并代谢综合征的患者其痴呆的恶化进程较不合并代谢综合征者明显加快。
Objective To evaluate the relationship between patients with multi-infarct dementia (MID) and metabolic syndrome (Mets). Methods Eighty-five patients with cerebral infarction who were hospitalized in neurology department were enrolled. All patients were divided into Metabolic syndrome group (Mets group, 39 cases) and non-Metabolic syndrome group (46 cases). All patients were assessed for dementia and neurological deficit at admission, on the first month and on the sixth month, and measured waist circumference, blood pressure, blood lipid-related indicators of venous blood test, fasting blood glucose (FPG) Insulin resistance (IR) = FINS × FPG / 22.5 was assessed by HOMA at 2 h postprandial glucose, HbAlc and FINS. Oral glucose tolerance test (OGTT) was performed if necessary. Results The incidence of multi-infarction dementia in the first month and the sixth month were 59.0%, 64.1% and 61.5% respectively in the Mets group and 32.6%, 34.8% and 34.8% in the NMets group respectively. There were significant differences in the incidence of multi-infarction dementia between the two groups at the first month and the sixth month after admission (P <0.05). The severity of dementia in Mets group was significantly higher than that in NMets group, Of the first month, the risk of vascular dementia was significantly increased (P <0.05). Conclusions Metabolic syndrome is associated with a significantly increased risk of developing multi-infarct dementia in patients with multiple cerebral infarction. For patients with multiple metabolic syndrome-associated cerebral infarction, the highest risk of vascular dementia occurs at the first month of onset, and vascular dementia Patients, patients with metabolic syndrome dementia progression worse than those without metabolic syndrome.