The metabolic X-syndrome in patients with ischemic stroke

Abstract

The metabolic X syndrome (MXS) represents a complex of metabolic, hormonal infringements and clinical displays, is a cardiovascular factor of risk. Criteria of diagnostics of MXS include: intolerance of glucose or a diabetes and/or resistance to insulin with 2 or more signs from listed more low: - the raised arterial pressure (> 160/90 mm Hg); - raised triglycerides plasmas (> 1,7 mmol/1 and/or HDL-cholesterol lowered (<0,9 mmol/1 at men; <1 mmol/1 at women); - visceral adiposity; - microalbuminuria (> 20 microgr/min). Aims. Definition of prevalence MXS at patients with an ischemic stroke, level fmding-out glicemia and its evolution in dynamics, correlations MXS with disease, death rate and duration of stay of patients in chamber of intensive therapy, duration of hospitalisation. For revealing of presence MXS diagnostic criteria NCEP (National Cholesterol Education Program) have been used. Risk factors NCEP III 1. Adiposity Circle of a waist >102 cm at men and >88 cm at women 2. Blood pressure >130/>85mmHg 3. Glicemia a jeun >110 mg/dl 4. Triglycerides >150 mg/dl 5.HDL-cholesterol <40 mg/dl at men, <50 mg/dl at women. The positive diagnosis is exposed at any 3 factors. 322 patients have been included in research with acute ischemic stroke. Middle age of patients of 66,85 years (40-89 years). The parity of the man/woman makes 1/1,19. MXS has been revealed at 45 % of patients. The diabetes is defined at 19,6 % of patients with a stroke. Hyperglycemia prevails at women (47,6 %), at men - 42.9 %. 32,6 % of patients with MXS had a massive ischemic stroke, at patients without MXS - 19,8 %. In the executed research the volume of a zone of a cerebral ischemia correlates with presence or absence of risk factors which are defined MXS. Average mortality studied patients - 15,8 %, strictly correlating with level of glicemia at hospitalisation. Term of hospitalisation at patients with MXS - 10,9 days, at patients without this syndrome - 9,2 days. Term of stay of patients with MXS in chamber of intensive therapy much more longer (5,3 days in comparison with 3,1 days). Thus, patients with MXS are needed longer intensive therapy, and also additional expenses is necessary for treatment of complications for these patients. MXS widespread in a society. MXS contributes to development of strokes by means of such risk factors as adiposity, an arterial hypertension, a diabetes, endothelial dysfunction, hypercoagulation, and dyslipidemia. Frequency of a massive ischemic stroke in 1,65 times more at patients with MXS. Death rate of patients with MXS in 3 times above and duration of hospitalisation in 1,7 times more. At such patients complications is more often come to light and later there comes rehabilitation. Therefore timely diagnostics MXS allows to warn expansion of a zone of a cerebral infarct.