代谢综合征与颅内外动脉粥样硬化性狭窄的相关性研究

目的:探讨代谢综合征(Metabolic syndrome,MS)与颅内外动脉粥样硬化性病变的相关性。方法:连续收集579例因急性脑梗塞或血管性危险因素入院的患者,借助经颅多普勒超声和/或核磁共振血管成像明确有无颅内外动脉粥样硬化性狭窄,分为狭窄组和非狭窄组;采用IDF的MS诊断标准,明确两组MS的发生率;分析颅内外动脉粥样硬化性狭窄的危险因素,并探讨MS与颅内、颅外动脉粥样硬化性狭窄的相关性。结果:1、狭窄组和非狭窄组MS的发生率分别为71.26%,58.43%,两组比较有统计学差异(P=0.0015)。2、与脑动脉粥样硬化性狭窄相关的危险因素依次为:脑梗塞病史、高血糖、高胆固醇血症、高血压、低HDL血症,年龄,MS并非脑动脉粥样硬化性狭窄的独立危险因素,OR0.798。3、MS与颅内动脉粥样硬化性狭窄相关,OR1.736,但其风险依赖于其组分中的高血糖、高血压及低HDL血症;MS与颅外动脉粥样硬化性狭窄不相关,OR1.466。结论:MS不是脑动脉粥样硬化性狭窄的独立危险因素,MS与颅内动脉粥样硬化性狭窄相关,但这种危险性依赖于MS各组分,MS与颅外动脉粥样硬化性狭窄无相关性。

The analysis of the relationship between Metabolic syndrome and intra-and extra-cranial atherosclerotic stenosis

Objective：To investigate the influence of the Metabolic syndrome（MS） on intra-and extra-cranial atherosclerotic stenosis.Methods：We studied 579 patients with acute ischemic stroke or with risk factors for cardiovascular disease who were consecutively hospitalized.All patients underwent Transcranical Doppler（TCD） or/and Magnetic Resonance Angiography（MRA） to measure the intra-and extra-cranial atherosclerotic stenosis.All subjects were invided into group with stenosis and group without stenosis;We used the criteria of MS published by International Diabetes Federation（IDF） to reveal the incidences of MS.We analyzed the risk factors on intra-and extra-cranial atherosclerotic stenosis and to explore the relationship between MS and intra-and extra-cranial atherosclerotic stenosis.Results：1.The incidences of MS in group with or without stenosis were 71.26%,58.43%,respectively,there was statistical significance between the two groups（P=0.0015）.2.The significant risk predictors of cerebrovascular stenosis was as follows：ischemic stroke history,hyperglycaemia,hypercholesteremia,hypertension,lowered serum high-density lipoprotein cholesterol level,age.The presense of MS didn＇t an independent risk factor for cerebrovascular stenosis.3.Further analysis indicated MS was associated with intracranial artery stenosis,OR 1.736,The associated MS parameters are hyperglycaemia,hypertension,lowered serum high-density lipoprotein cholesterol level.The MS was uncorrelated with extracranial artery stenosis,OR1.466.Conclusion：MS is not an independent risk factor for cerebrovascular stenosis.MS was associated with intracranial atherosclerotic stenosis,but the risk from MS was depended on its individual components.MS was not associated with extracranial atherosclerotic stenosis.