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Please use this identifier to cite or link to this item: http://hdl.handle.net/20.500.12710/3098
Title: Accidentul vascular cerebral ischemic şi sindromul metabolic
Other Titles: Stroke and metabolic syndrome
Ишемический инсульт и метаболический синдром
Authors: Ciobanu, Natalia
Groppa, Stanislav
Keywords: Dyslipidemia
Issue Date: 2015
Publisher: Buletinul Academiei de Ştiinţe a Moldovei. Ştiinţe Medicale
Abstract: Rezumat Accidentul vascular cerebral (AVC-ul) este a doua cauză de mortalitate în lume după afecţiunile cardiace [1, 2], fi ind o cauză majoră a dizabilităților în țările înalt dezvoltate. Incidenţa actuală a AVC-urilor și lipsa unor metode efi ciente de prevenire şi tratament au condus la aprofundarea cercetării factorilor de risc [2, 3]. Sindromul metabolic (SM) reprezintă una dintre verigile principale ale patogeniei AVC-urilor. Există studii care au arătat că în SM, prezenţa simultană a factorilor multipli de risc cardiovasculari dublează riscul pentru AVC [11, 18]. Frecvenţa SM printre pacienţii cu AVC, în literatura de specialitate, variază în funcţie de criteriile utilizate pentru defi nirea SM între 46%-69% [7, 14, 15, 16]. Am efectuat un studiu retrospectiv al foilor de observaţie a 45 pacienţi cu vârsta cuprinsă între 40 - 85 ani cu SM şi AVC ischemic. Pentru selectarea pacienţilor am aplicat ultima defi niţie existentă la ora actuală la nivel mondial pentru SM, propusă în 2009 de American Heart Association (AHA), National Heart, Lung and Blood Institute (NHLBI) şi International Diabetes Federation (IDF). Am comparat prevalenţa următorilor factori de risc: hipertensiune arterială (HTA), obezitate, hiperglicemie a jeun, dislipidemie. În cercetarea noastră creşterea circumferinţei abdominale s-a constatat la toţi cei 45 pacienţi (100%), circumferinţa abdominală medie la femei fi ind de 106,5 cm, iar la bărbaţi – 109,3 cm. HTA a fost prezentă la 95%, cu predominarea HTA gr. 3 – 27 (60%). Dislipidemie s-a constatat la 22 bolnavi (48,8%). Hiperglicemia cronică s-a constatat la 43 pacienţi (93,3%). Distribuţia în dependenţă de numărul factorilor de risc este următoarea: SM a fost defi nit după 3 criterii la 25 de bolnavi (56,6%), după 4 criterii la 15 (33,4%) şi după 5 criterii la 4 pacienţi (9%). Stroke is the second most frequent cause of death worldwide after ischaemic heart disease and is a leading cause of disability in highly developed countries [1, 2]. The current incidence of stroke and the lack of effective treatment measures have led to the need for further research risk factors [2, 3]. The metabolic syndrome represents one of the most important elements of the pathogenesis of strokes. Several studies have shown that in MS, the simultaneous presence of multiple risk factors for cardiovascular disease doubles the risk of stroke [11, 18]. The frequency of patients with SM between the patients with stroke will vary depending on the criteria used to defi ne the MS between 46% -69% [7, 14, 15, 16]. We conducted a retrospective study in patients with metabolic syndrome and fi rst acute ischaemic stroke that occurred between the ages of 40 and 85 years. To select patients we applied the latter defi nition available worldwide for MS, proposed in 2009 by the American Heart Association (AHA), National Heart, Lung and Blood Institute (NHLBI) and the International Diabetes Federation (IDF). We compared the prevalence of the following risk factors: elevated blood pressure, obesity, high fasting blood glucose and abnormal lipids. In our research increased waist circumference was found in all 45 patients (100%), abdominal circumference average being 106.5 cm in women and 109.3 cm in men. Hypertension was present in 95%, prevailed stage 3 hypertension - 27 (60%). Dyslipidemia was found in 22 patients (48.8%). Chronic hyperglycemia was found in 43 patients (93.3%). The distribution depending on the number of risk factors are as follows: MS defi ned by three criteria to 25 patients (56.6%), by 4 criteria 15 (33.4%) and by fi ve criteria in 4 patients (9%). Цереброваскулярные заболевания занимают второе место в структуре общей смертности населения и первое место в причинах инвалидизации взрослого населения во всём мире [1, 2]. Высокая частота заболеваемости, отсутствие эффективных методов профилактики и лечения свидетельствуют о необходимости дальнейшего ис- следования факторов риска инсульта [2, 3]. Одним из ключевых звеньев патогенеза инсульта является метаболи- ческий синдром (МС). При МС, одновременное присутствие нескольких факторов риска сердечно-сосудистых заболеваний удваивают риск развития инсульта [11, 18]. Частота МС у пациентов c инсультом составляет 46% -69% в зависимости от используемых критериев определения МС [7, 14, 15, 16]. Мы провели ретроспективное исследование пациентов в возрасте 40-85 лет c метаболическим синдромом и инсультом. Верификация МС про- водилась согласно критериям American Heart Association (AHA), National Heart, Lung and Blood Institute (NHLBI) и International Diabetes Federation (IDF) (2009). Мы определяли распространенность следующих факторов риска: гипертония, ожирение, гипергликемия натощак и дислипидемия. В нашем исследовании увеличение окружности талии былo найденo y всех 45 больных (100%), окружности живота в среднем была 106,5 см у женщин и 109,3 см у мужчин. Артериальная гипертензия выявлена у 95%, распространенность гипертонии 3 ст. - 27 (60%). Дис- липидемия было обнаружено у 22 (48,8%) пациентов. Хроническая гипергликемия былa найденa у 43 (93,3%) пациентов. Распределение в зависимости от факторов риска следующая: МС определен по трем критериям у 25 пациентов (56,6%), по 4 критериям - 15 (33,4%) и по пяти критериям - 4 пациентов (9%).
URI: http://www.asm.md/administrator/fisiere/editii/f55.pdf
http://repository.usmf.md/handle/20.500.12710/3098
ISSN: 1857-0011
Appears in Collections:ARTICOLE ȘTIINȚIFICE

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