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糖尿病与中风:流行病学、病理生理学、药物治疗及预后

Diabetes and Stroke: Epidemiology, Pathophysiology, Pharmaceuticals and Outcomes.

作者信息

Chen Rong, Ovbiagele Bruce, Feng Wuwei

机构信息

Department of Neurology, Affiliated Hospital of Hainan Medical College, Haikou, Hainan, China; Department of Neurology, MUSC Stroke Center, Medical University of South Carolina, Charleston, South Carolina.

Department of Neurology, MUSC Stroke Center, Medical University of South Carolina, Charleston, South Carolina.

出版信息

Am J Med Sci. 2016 Apr;351(4):380-6. doi: 10.1016/j.amjms.2016.01.011.

Abstract

There has been a significant increase in obesity rates worldwide with the corresponding surge in diabetes. Diabetes causes various microvascular and macrovascular changes often culminating in major clinical complications, 1 of which, is stroke. Although gains have been made over the last 2 decades in reducing the burden of stroke, the recent rise in rates of diabetes threatens to reverse these advances. Of the several mechanistic stroke subtypes, individuals with diabetes are especially susceptible to the consequences of cerebral small vessel diseases. Hyperglycemia confers greater risk of stroke occurrence. This increased risk is often seen in individuals with diabetes and is associated with poorer clinical outcomes (including higher mortality), especially following ischemic stroke. Improving stroke outcomes in individuals with diabetes requires prompt and persistent implementation of evidence-based medical therapies as well as adoption of beneficial lifestyle practices.

摘要

全球肥胖率显著上升,糖尿病也相应激增。糖尿病会引发各种微血管和大血管变化,常常导致严重的临床并发症,其中之一就是中风。尽管在过去20年里在减轻中风负担方面取得了进展,但近期糖尿病发病率的上升有可能使这些进展逆转。在几种机制性中风亚型中,糖尿病患者尤其易患脑小血管疾病的后果。高血糖会增加中风发生的风险。这种增加的风险在糖尿病患者中很常见,并且与较差的临床结局(包括更高的死亡率)相关,尤其是在缺血性中风之后。改善糖尿病患者的中风结局需要迅速且持续地实施循证医学疗法以及采取有益的生活方式。

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