Mankovsky B N, Metzger B E, Molitch M E, Biller J
Center for Endocrinology, Metabolism and Molecular Medicine, Northwestern University Medical School, Chicago, Illinois 60611-3008, USA.
J Diabetes Complications. 1996 Jul-Aug;10(4):228-42. doi: 10.1016/s1056-8727(96)90006-9.
Diabetes mellitus is a risk factor for ischemic, but not hemorrhagic stroke. The frequency of transient ischemic attacks is not increased in patients with diabetes compared to the general population. Diabetes mellitus is associated with higher mortality, worse functional outcome, more severe disability after stroke and a higher frequency of recurrent stroke. Diabetes is not associated with an increased size of cerebral infarction. Controversy exists regarding whether hyperglycemia adversely affects stroke outcome or primarily reflects stroke severity. Cerebral blood flow disturbances, impaired cerebrovascular reactivity, and damage to large and small extra- and intracranial cerebral vessels have been found in humans and animals with diabetes. Combinations of some or all of these factors may underlie the high incidence and worse outcome of stroke in patients with diabetes. Knowledge of these pathophysiologic factors will assist in the design of future intervention strategies.
糖尿病是缺血性卒中的危险因素，但不是出血性卒中的危险因素。与普通人群相比，糖尿病患者短暂性脑缺血发作的频率并未增加。糖尿病与较高的死亡率、较差的功能预后、卒中后更严重的残疾以及较高的复发性卒中频率相关。糖尿病与脑梗死面积增大无关。关于高血糖是对卒中预后产生不利影响还是主要反映卒中严重程度，目前存在争议。在患有糖尿病的人类和动物中，已发现脑血流紊乱、脑血管反应性受损以及颅内和颅外大小脑血管受损。这些因素中的部分或全部组合可能是糖尿病患者卒中发病率高和预后较差的原因。了解这些病理生理因素将有助于未来干预策略的设计。
