Zhang X-D, Chen Y-R, Ge L, Ge Z-M, Zhang Y-H
School of Life Science, Lanzhou University, Lanzhou 730000, The People's Republic of China.
J Int Med Res. 2007 Jul-Aug;35(4):540-6. doi: 10.1177/147323000703500414.
In this study, demographic characteristics, risk factors, stroke subtypes and outcome were compared in 2532 patients with and without diabetes hospitalized for first-ever stroke. Diabetes was present in 471 (18.6%) of the patients. Patients with diabetes presented more frequently with ischaemic stroke (92.1% versus 71.3%), especially lacunar infarction (41.2% versus 35.2%), compared with non-diabetics. Cerebral haemorrhage was less frequent in diabetics than non-diabetics (4.2% versus 18.1%). In-hospital mortality rates from ischaemic stroke were similar in the two groups (18.2% in diabetics and 16.9% in non-diabetics). Predictors of in-hospital mortality in diabetic patients included decreased consciousness, congestive heart failure and atrial fibrillation. In conclusion, stroke in diabetic patients was different to stroke in non-diabetic patients: in diabetics the frequency of cerebral haemorrhage was lower and the rate of lacunar infarct syndrome was higher, but in-hospital mortality from ischaemic stroke was not increased. Clinical factors evident at the onset of stroke have a major influence on in-hospital mortality and may help clinicians provide a more accurate prognosis.
在本研究中，对2532例首次因中风住院的糖尿病患者和非糖尿病患者的人口统计学特征、危险因素、中风亚型及转归进行了比较。471例（18.6%）患者患有糖尿病。与非糖尿病患者相比，糖尿病患者缺血性中风更为常见（92.1%对71.3%），尤其是腔隙性梗死（41.2%对35.2%）。糖尿病患者脑出血的发生率低于非糖尿病患者（4.2%对18.1%）。两组缺血性中风的院内死亡率相似（糖尿病患者为18.2%，非糖尿病患者为16.9%）。糖尿病患者院内死亡的预测因素包括意识减退、充血性心力衰竭和心房颤动。总之，糖尿病患者的中风与非糖尿病患者不同：糖尿病患者脑出血发生率较低，腔隙性梗死综合征发生率较高，但缺血性中风的院内死亡率并未增加。中风发作时明显的临床因素对院内死亡率有重大影响，可能有助于临床医生提供更准确的预后。
