| Objective: Stroke seriously jeopardizes human health and life. It is oneof the three leading causes of death and the largest cause of adult disability inthe world, which gives a heavy burden to both the family and thesociety.Type2diabetes has been an important and independent risk factor forischemic stroke. Diabetes significantly increases the incidence of stroke,which also has been associated with a worse functional outcome and increasedmortality after ischemic stroke. With the increase of the prevalence ofdiabetes, diabetes mellitus cerebral infarction is drawing more attention ofpeople. The aim of this study was to improve the knowledge of cerebralinfarction with type2diabetes, by evaluating the features of onset, clinicalmanifestations, and image features in patients with diabetes compared withthose without diabetes．Methods: We consecutively collected100patients with cerebralinfarction from the neurology department of the2nd Hospital affiliated toHebei Medical University (admission from July2011to November2011). Allof the100cases were eligible for the diagnostic criteria revised in the FourthNational Cerebrovascular Disease Conference in1995and were confirmed bycomputerized tomography (CT) or magnetic resonance imaging (MRI).Allwere admitted within7days (age,30-90years; mean age,61.63±11.44years)．Patients with atrial fibrillation, malignant tumor, liver and renalinsufficiency or heart failure were excluded. The patients were divided intodiabetic group and non-diabetic group according to if they had the history ofdiabetes and excluded the possibility of post stroke hyperglycemia ascribed tostress, and both the two groups had50cases. The diagnosis of type2diabetes mellitus was based on the WHO criteria revised in1997．Wecollected the general data (gender, age, history of other diseases, previous TIA, smoking, alcohol intake), the severity of neurological deficit (assessed by thenation institutes of health stroke scale, NIHSS), biochemical parameters(plasma-lipoids, fibrinogen), stroke in progressing, stroke recurrent or not, andimage features. We used SPSS17.0statistical analysis software. Themeasurement data were analyzed by Two-sample t-test, while the numerationdata were analyzed by chi-square test, P<0.05as had statistical significance.Results:1General parameters:1.1Sex and age: in the case group,23cases (46%) were male, the average agewas62.32±10.98, the average age of first stroke was61.24±10.31; In thecontrol group,32cases (64%) were male, the average age was60.94±11.94,the average age of first stroke was59.92±11.16. There was no statisticaldifference between two groups (p>0.05)1.2History of other risk factors: the diabetic group has a higher incidence ofhypertension and coronary disease, and the difference had statisticalsignificance (p<0.05). However there was no significant difference inprevious TIA, smoking history, and alcohol intake between the two groups(p>0.05).2Comparison of biochemical parameters: in the diabetic group, totalcholesterol (CHOL), Triglyceride (TG), and low density lipoproteincholesterol (LDL-C) were all higher than in the non diabetic group. Thedifference had statistical significance (p<0.05). However there was nosignificant difference in high density lipoprotein-cholesterol (HDLC) andfibrinogen (FIB) between the two groups (p>0.05)3Clinical characteristics3.1The severity of neurological deficit: In the case group, there were26caseswith mild neurological deficit and24cases with moderate neurological deficit,while there were31cases with mild neurological deficit and24cases withmoderate neurological deficit. Both had no severe neurological deficit cases.There was no statistical difference between the two groups in the severity ofneurological deficit (p>0.05). The two subsets of the diabetic group had no statistical difference in the level of admission fasting blood glucose,glycosylated hemoglobin and duration of diabetes (p>0.05).3.2Stroke in progressing: In the case group, there were13cases aggravated(26%), while4cases (8%) aggravated in the control group. The difference hadstatistical significance (p<0.05).3.3Recurrent or initial infarction: In the case group,29cases (58%) sufferedinitial cerebral infarction,21cases (42%) were recurrent, while there were39(78%) and11(22%) separately in the control group. The difference hadstatistical significance (p<0.05).4Neuroimaging feature4.1The subtype of stroke: There were23cases with large arteryatherosclerosis infarction and27cases with lacunar infarction in the diabeticgroup compared with29large cases with artery atherosclerosis infarction and21cases with lacunar infarction in the control group. There was no statisticaldifference between the two groups in the subtypes of stroke (p>0.05).4.2Lesion location: In the case group, there were29cases (58%) withanterior circulation infarcts and21(42%) cases with posterior circulationinfarcts, of which20cases were located in basal ganglia–corona radiate and13were at brainstem. In the control group, there were34cases (68%) withanterior circulation infarcts and16(32%) cases with posterior circulationinfarcts, of which22cases were located in basal ganglia–corona radiate and8were at brainstem. There was no statistical difference between the two groupsin the lesion location (p>0.05).Conclusions:1Diabetes mellitus cerebral infarction has no difference in age, sex ratio,previous TIA, the severity of neurological deficit and stroke subtype,compared with the non-diabetes mellitus group.2Diabetic patients, compared with those without diabetes, had a higherincidence of hypertension and hyperlipemia and were more likely to havestroke in progressing and recurrent stroke.3There was no significant difference in the lesion location between the diabetes mellitus cerebral infarction group and the non-diabetes mellitusgroup, both of which mainly involved the anterior circulation and had thebasal ganglia–corona radiate as the major lesion location.4The severity of neurological deficit of the diabetes mellitus cerebralinfarction is not related to the level of admission fasting blood glucose,glycosylated hemoglobin and the duration of diabetes. |
PDF Full Text Request