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高血压合并2型糖尿病老年患者缺血性卒中发生的影响因素:一项病例对照研究

Factors influencing the occurrence of ischemic stroke in elderly patients with hypertension and type 2 diabetes mellitus: a case-control study.

作者信息

Li Chujun, Chen Yuzhen, Ou Xiuli, You Tianhui

机构信息

College of Nursing, Guangdong Pharmaceutical University, Guangzhou, Guangdong, 510006, China.

Nursing Department, Jiangmen Central Hospital, Jiangmen, Guangdong, 529000, China.

出版信息

BMC Neurol. 2025 Jan 24;25(1):35. doi: 10.1186/s12883-025-04022-w.

Abstract

OBJECTIVE

To investigate the risk factors for ischemic stroke in elderly patients with hypertension and type 2 diabetes mellitus.

METHODS

A total of 112 elderly patients with hypertension and type 2 diabetes, treated at Jiangmen Central Hospital from January 2023 to December 2023, were selected and categorized into a stroke group and a non-stroke group, each comprising 56 patients. The two groups were examined for demographic data, risk variables were evaluated by multifactorial logistic regression analysis, and the predictive value was determined using ROC curves.

RESULTS

The comparison of hyperhomocysteinemia (HHcy), fibrinogen (FIB), and high-density lipoprotein cholesterol (HDL-C) between the non-stroke and stroke groups revealed statistically significant differences (P < 0.05). Logistic regression analysis indicated that HHcy (OR 16.936; 95% CI 1.946-146.071; P = 0.010), FIB (OR 1.773; 95% CI 1.238-2.540; P = 0.002), and HDL-C (OR 0.182; 95% CI 0.043-0.775; P = 0.021) were significant factors in the onset of ischemic stroke among elderly patients with hypertension and type 2 diabetes. ROC curve analysis revealed that the area under the curve (AUC) for FIB, HDL-C, and HHcy in diagnosing stroke associated with hypertension and type 2 diabetes mellitus in the elderly were 0.704, 0.640, and 0.598, respectively, while the AUC for the combined diagnosis of all three was 0.784.

CONCLUSIONS

HHcy, FIB, and HDL-C independently influence the occurrence of ischemic stroke in elderly patients with hypertension combined with type 2 diabetes mellitus, and their combined enhanced predictive capability for ischemic stroke occurrence.

摘要

目的

探讨老年高血压合并2型糖尿病患者缺血性卒中的危险因素。

方法

选取2023年1月至2023年12月在江门市中心医院治疗的112例老年高血压合并2型糖尿病患者,分为卒中组和非卒中组,每组56例。对两组患者进行人口统计学数据检查,通过多因素逻辑回归分析评估风险变量,并使用ROC曲线确定预测价值。

结果

非卒中组与卒中组之间高同型半胱氨酸血症(HHcy)、纤维蛋白原(FIB)和高密度脂蛋白胆固醇(HDL-C)的比较显示出统计学上的显著差异(P < 0.05)。逻辑回归分析表明,HHcy(OR 16.936;95%CI 1.946 - 146.071;P = 0.010)、FIB(OR 1.773;95%CI 1.238 - 2.540;P = 0.002)和HDL-C(OR 0.182;95%CI 0.043 - 0.775;P = 0.021)是老年高血压合并2型糖尿病患者缺血性卒中发病的重要因素。ROC曲线分析显示,FIB、HDL-C和HHcy在诊断老年高血压合并2型糖尿病相关性卒中时的曲线下面积(AUC)分别为0.704、0.640和0.598,而三者联合诊断的AUC为0.784。

结论

HHcy、FIB和HDL-C独立影响老年高血压合并2型糖尿病患者缺血性卒中的发生,且它们联合对缺血性卒中发生的预测能力增强。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aacb/11758724/c25b690b3dd2/12883_2025_4022_Fig1_HTML.jpg

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