Brain Lesions in Patients with Type 2 Diabetes Mellitus
The objective of research — to establish the causes and patterns of structural and functional changes in the brain of patients with type 2 diabetes with ischemic stroke in order to improve the diagnosis, evaluation of the course, prognosis of diabetic encephalopathy and to design therapeutic programs. Materials and Methods. The study included 557 people, among them 288 men and 269 women, with ischemic stroke, mean age 64.6 ± 10.3 years. Results. Brain lesions in type 2 diabetes are heterogeneous, have two different niduses, which subsequently potentiate each other: vascular cause that is based on chronic hypoxia on the background of «echeloned» stenosis of cerebral arteries and violations in neurovascular unit structures, as well as extravascular cause which is based on inflammatory process in brain tissue, characterized by macrophage-microglial activation, penetration of antigen-presenting cells through the blood-brain barrier and lesion of neuronal and glial cell pools. Conclusions. The most important factors associated with the development of stroke and diabetes mellitus type 2 are female gender, medical history of hypertension, coronary heart disease, atrial fibrillation, alcohol abuse. Major anamnestic risk factors associated with mortality in the acute phase of stroke are: myocardial infarction, atrial fibrillation, coronary heart disease, female gender, age 70–80 years, smoking. The most common subtype of ischemic stroke in patients with diabetes mellitus is a lacunar stroke. Type 2 diabetes mellitus is an independent risk factor for the reduction of intellectual functions.
Full Text:PDF (Русский)
Гусев Е.И. Проблема инсульта в России // Журнал неврологии и психиатрии имени С.С. Корсакова. — 2003. — 9. — 5-7.
Скворцова В.И., Стаховская Л.В., Айриян Н.Ю. Эпидемиология инсульта в Российской Федерации // Consilium Medicum. — 2005. — 1. — 10-12.
Gorelick P.B. Stroke prevention therapy beyond antithrombotics: unifying mechanisms in ischemic stroke pathogenesis and implications for therapy // Stroke. — 2002. — 33. — 862.
Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of antioxidant vitamin supplementation in 20536 high-risk individuals: a randomized placebo-controlled trial // Lancet. — 2002. — 360. — 23-33.
Sandercock P. Statins for stroke prevention? // Lancet. — 2001. — 357. — 1548-49.
LaRosa J.C., Grundy S.M., Waters D.D. et al. for the Treating to New Targets (TNT) investigators. Intensive lipid lowering with atorvastatin in patients with stable coronary disease // N. Engl. J. Med. — 2005. — 352(14). — 1425-1435.
The Stroke Prevention by Aggressive Reduction in Cholesterol Level (SPARCL). Investigators «High-dose atorvastatin after stroke or transient aschemic attac» // New Engl. J. Med. — 2006. — 355. — 549-559.
This work is licensed under a Creative Commons Attribution 4.0 International License.
© "Publishing House "Zaslavsky", 1997-2018