【作者】 陈明星；

【导师】 徐安定；

【作者基本信息】 暨南大学 ， 神经病学， 2003， 硕士

【摘要】 目的：以TCD检测的脑动脉异常率和TCD检测半定量评分为参数，探讨糖尿病患者年龄、病程、血压、血脂和尿酸等相关危险因素与糖尿病患者无症状性脑动脉病变的关系；为研究TCD检测的糖尿病患者无症状性脑动脉病变是否可作为中风的独立危险因素建立数据库。 方法：收集199例未中风糖尿病住院病人的病历资料，包括相关实验室资料和TCD检查数据，排除合并任何急性脑血管病和其他颅内疾病的患者。对TCD检测结果进行半定量评分。SPSS11.0统计包分析TCD检测动脉异常率和TCD检测半定量评分与年龄、糖尿病病程、血压、血脂有关代谢指标、血尿酸的相关性。 结果：1、性别与TCD检测的脑动脉异常率和TCD半定量评分无关，年龄与脑动脉异常率呈直线相关，其中血速增快异常率和颈动脉系统各动脉异常率受年龄影响明显。2、TCD检测的脑动脉异常率与病程相关。随着病程的延长，中青年糖尿病患者MCA、OA，老年糖尿病患者ICA，VA异常率显著增加。3、TCD检测半定量评分与年龄和病程呈直线相关。4、多元线形回归显示TCD检测的脑动脉异常率与血甘油三脂、低密度脂蛋白、尿酸水平相关，TCD检测半定量评分与血低密度脂蛋白和舒张压呈直线相关。 结论：TCD检测动脉异常率和半定量评分能更敏感地反映糖尿病患者无症状性脑动脉病变的特点。年龄、糖尿病病程、血甘油三脂、低密度脂蛋白、尿酸及舒张压是糖尿病患者无症状性脑动脉病变的危险因素。TCD检测的糖尿病患者无症状性脑动脉病变特点与中风相关特点吻合，有可能作为预测糖尿病患者中风危险度的指标。更多还原

【Abstract】 Objectives: To analyze the risk factors correlation of asymptomatic cerebralarterial pathological changes in patients with diabetes mellitus (DM). To collect cases into our databank, for a follow-up study to concerns the relationship between asymptomatic cerebral arterial pathological changes reflected with TCD and stroke in patients with diabetes mellitus.Methods: Inpatients with diabetes mellitus who had been examined withtranscranial Doppler sonography (TCD) were included in this study. The exclusion criteria were mainly any kinds of stroke and stroke history, or other intracranial disorders. All correspondent clinical information including detailed history, laboratory data, and TCD results was collected. After analyses of TCD results, two kinds of self-made parameters, Rate of Artery Abnormality (TCD-RAA) and TCD Semi-Quantitative Score (TCD-SQS) were used to reflect the asymptomatic cerebral arterial pathological changes. The correlations of TCD-RAA, TCD-SQS to age, duration of disease, blood pressure, hyperlipidemia, hyperuriemia, etc, were statistically analyzed with SPSS 11.0 software.Results: 1. No relation of sex to TCD-RAA and TCD-SQS was found. TCD-RAAwas lineally correlated to age; among them the correlations of age to TCD-RAA in carotid artery system and the rate of increased flow velocity arteries (RIVA) were more obvious. 2. TCD-RAA was significantly coorelated to duration of DM. With the prolonging of duration of DM, the TCD-RAA of MCA and OA in youth-middle aged diabetics, TCD-RAA of ICA and VA in old aged diabetics signifivantly increased. 3. TCD-SQS was lineally correalted to age and duration of DM. 4. Correaltions of TCD-RAA to serum levels of triglyceride, low density lipoprotein and uric acid were evident, and linear correaltions of TCD-SQS to serum level of low density lipoprotein and diastolic blood pressure were found.Conclusions: Rate of Artery Abnormality (TCD-RAA) and TCDSemi-Quantitative Score (TCD-SQS) can reflect the features of asymptomatic cerebral arterial pathological changes of DM . Age, duration of DM, elevated serum levels of Triglyceride, low density lipoprotein, uric acid and diastolic blood pressure are risk factors for asymptomatic cerebral arterial pathological changes of DM. The features of asymptomatic cerebral arterial pathological changes in diebetics reflected with TCD-RAA and TCD-SQS are in accord with the clinical features of strok to some degree, indicating that asymptomatic cerebral arterial pathological changes of DM reflected with TCD may be the paramaters to predict strok in diabetics.更多还原