在沙特阿拉伯的一家三级中心，糖尿病与缺血性卒中和短暂性脑缺血发作的关系。
The association of diabetes with ischemic stroke and transient ischemic attacks in a tertiary center in Saudi Arabia.
机构信息
From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
出版信息
Ann Saudi Med. 2020 Nov-Dec;40(6):449-455. doi: 10.5144/0256-4947.2020.449. Epub 2020 Dec 3.
BACKGROUND
Diabetes mellitus increases stroke risk 1.5 to 3 fold, particularly ischemic stroke. There is limited literature on the impact of diabetes on stroke patients in Saudi Arabia.
OBJECTIVES
Determine the association of diabetes on the presentation, subtypes, in-hospital complications and outcomes of ischemic stroke and transient ischemic attacks (TIA).
DESIGN
IRB approved, retrospective chart review.
SETTING
Tertiary care center.
PATIENTS AND METHODS
All adult patients with ischemic stroke or TIA aged 18 years or older admitted from January 2016 to December 2017 were included.
MAIN OUTCOME MEASURES
Stroke severity at presentation, stroke-related complications, discharge disposition and discharge modified Rankin Scale (mRS) in relation to diabetes.
SAMPLE SIZE
802 patients.
RESULTS
Among 802 cases, 584 (72.8%) had diabetes; the majority (63.1%) were males. The mean age was younger in the non-diabetic stroke group (54.6 [15.5] years vs. 63.3 [9.9], <.001). Hypertension (83.6% vs 49.1%, <.001), dyslipidemia (38.9% vs. 28.9%, =.009), prior stroke (27.7% vs. 19.3% =.014), and ischemic heart disease (20.4% vs. 7.8%, <.001) were more common in diabetic patients whereas smoking was more common (19.3% vs. 11.1%, =.003) in the non-diabetic patients. The commonest subtype of stroke was large artery disease followed by small vessel disease. Both were more common in diabetic vs. non-diabetic patients (55.8% vs. 44%, =.003), and (16.6% vs. 11%, =.05) respectively. Diabetic stroke patients were more likely to have lacunar stroke (16.4% versus 9.2%, =.009). TIAs occurred more commonly in the non-diabetic group (26.1% vs. 13.7%, <.001). Non-diabetic patients had a better outcome (mRS score of 0-2) at discharge (62.4% vs. 45.9%, =.002).
CONCLUSIONS
Almost three-fourth stroke patients were diabetic in our cohort. Diabetic stroke patients were older, had multiple vascular comorbid conditions, presented late to the hospital, and were likely to have more disability at the time of discharge. Large vessel atherosclerosis as well as lacunar infarctions were more common in diabetic stroke patients.
LIMITATIONS
Missing data about time of presentation in few patients, missing modified Rankin Scale score at discharge.
CONFLICT OF INTEREST
None.
背景
糖尿病使中风风险增加 1.5 至 3 倍，尤其是缺血性中风。沙特阿拉伯有关糖尿病对中风患者影响的文献有限。
目的
确定糖尿病对缺血性中风和短暂性脑缺血发作（TIA）患者的表现、亚型、住院并发症和结局的影响。
设计
IRB 批准的回顾性图表审查。
地点
三级护理中心。
患者和方法
纳入 2016 年 1 月至 2017 年 12 月期间年龄在 18 岁或以上因缺血性中风或 TIA 入院的所有成年患者。
主要观察指标
发病时的中风严重程度、与中风相关的并发症、出院情况和出院时改良 Rankin 量表（mRS）与糖尿病的关系。
样本量
802 例患者。
结果
在 802 例患者中，584 例（72.8%）患有糖尿病，其中大多数（63.1%）为男性。非糖尿病中风组的平均年龄较小（54.6[15.5]岁比 63.3[9.9]岁，<.001）。高血压（83.6%比 49.1%，<.001）、血脂异常（38.9%比 28.9%，=.009）、既往中风（27.7%比 19.3%，=.014）和缺血性心脏病（20.4%比 7.8%，<.001）在糖尿病患者中更为常见，而吸烟在非糖尿病患者中更为常见（19.3%比 11.1%，=.003）。最常见的中风类型是大动脉疾病，其次是小血管疾病。两者在糖尿病患者中均更为常见（55.8%比 44%，=.003）和（16.6%比 11%，=.05）。糖尿病中风患者更可能出现腔隙性中风（16.4%比 9.2%，=.009）。非糖尿病组 TIA 更为常见（26.1%比 13.7%，<.001）。非糖尿病患者出院时的结局（mRS 评分 0-2）更好（62.4%比 45.9%，=.002）。
结论
在我们的研究队列中，近四分之三的中风患者患有糖尿病。糖尿病中风患者年龄较大，存在多种血管合并症，到医院就诊较晚，出院时更可能存在残疾。大血管粥样硬化以及腔隙性梗死在糖尿病中风患者中更为常见。
局限性
少数患者就诊时间的数据缺失，出院时改良 Rankin 量表评分缺失。
利益冲突
无。
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