Abstract:

Objective To investigate the relationship between intracranial atherosclerotic Stenosis and metabolic syndrome at different blood glucose levels in patients with acute ischemic stroke (AIS). Methods A total of 352 AIS patients who were treated in Dept. of Neurology of our hospital between June 2013 and June 2016 were selected as the study group, and were divided into stenosis group (n =227) and non-stenosis group (n =125), according to the degrees of intracranial vascular stenosis. A total of 310 subjects with non-intracranial atherosclerotic stenosis who visited our hospital for medical examination in the same period were selected as the control group. Patients with metabolic syndrome in the study group were divided into 3 subgroups: normal glucose tolerance group, diabetic group, and hyperglycemia group (including impaired fasting glucose and impaired glucose tolerance). The levels of blood lipid in metabolic syndrome patients were measured, and the correlation between metabolic syndrome at different blood glucose levels and intracranial atherosclerotic stenosis was analyzed. Results Among 352 AIS patients, 195 cases were diagnosed as metabolic syndrome. The incidence of metabolic syndrome in the study group was significantly higher than that in the control group, which had significantly difference (P <0.05). The incidence of metabolic syndrome in the stenosis group was significantly higher than that in the non-stenosis group, which had significant difference (P <0.05). The proportion of metabolic syndrome patients with diabetes in the stenosis group was significantly higher than that in the non-stenosis group and control group, which had significant difference (P <0.05). There was no significant difference in the proportion of metabolic syndrome patients with hyperglycemia and impaired glucose tolerance in the stenosis group and non-stenosis group (P >0.05). Logistic regression analysis showed that there was a significant correlation between metabolic syndrome and intracranial atherosclerotic stenosis; and there was significant positive correlation between metabolic syndrome with diabetes, with low high density lipoprotein (HDL), high triglyceride (TG) and intracranial atherosclerotic stenosis risk. Conclusion Among AIS patients, the metabolic syndrome with diabetes, high blood TG, low HDL levels was closely associated with intracranial atherosclerosis stenosis.

Key words: Ischemic stroke; Atherosclerotic stenosis; Metabolic syndrome

摘要：

目的 探讨急性缺血性卒中患者颅内动脉粥样硬化性狭窄与不同血糖水平代谢综合征的相关性。 方法 选取2013年6月-2016年6月入住本院神经内科的急性缺血性卒中患者352例为研究对象，根 据颅内血管狭窄情况分为狭窄组227例和非狭窄组125例；选取同期非颅内动脉粥样硬化性狭窄体检 者310例为对照组。研究对象中合并代谢综合征的患者分为3个亚组：糖耐量正常组、伴糖尿病组、伴 高血糖组（包括空腹血糖受损、糖耐量降低）。同时测定代谢综合征患者血脂水平，分析不同血糖 水平代谢综合征与颅内动脉粥样硬化性狭窄的相关性。 结果 352例急性缺血性卒中患者共确诊代谢综合征195例（55.39%），其中狭窄组和非狭窄组代谢 综合征的发生率均明显高于对照组，比较差异有显著性（P <0.05）；狭窄组代谢综合征的发生率明显 高于非狭窄组，比较差异有显著性（P <0.05）。狭窄组中伴糖尿病的代谢综合征患者比例明显高于非 狭窄组和对照组，比较差异有显著性（P <0.05）；狭窄组中伴高血糖和糖耐量正常的代谢综合征患 者比例与非狭窄组比较，差异均无显著性（P＞0.05）。Logistic回归分析显示：代谢综合征与颅内动脉 粥样硬化性狭窄存在明显相关性；代谢综合征伴糖尿病、伴低高密度脂蛋白（high density lipoprotein， HDL）、高甘油三酯（triglyceride，TG）与颅内动脉粥样硬化性狭窄发生风险呈明显正相关。 结论 在急性缺血性卒中患者中，代谢综合征尤其是糖尿病、高TG血症及低HDL血症和颅内动脉粥 样硬化性狭窄密切相关。

关键词: 缺血性卒中; 动脉硬化性狭窄; 代谢综合征