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糖尿病可使发生缺血性卒中的风险增加2倍以上,并且合并缺血性卒中的糖尿病患者长期预后不良。目前所采取的强力降血糖治疗并未使糖尿病患者从缺血性卒中的一级和二级预防中获益。然而,有研究显示,具有针对性的缺血性卒中危险因素管理,特别是对不良生活方式、血糖、高血压、脂质代谢紊乱的干预,可预防糖尿病患者缺血性卒中的发生,并改善预后。在符合干预标准的糖尿病患者中,抗血栓治疗和颈动脉外科手术对缺血性卒中的一级和二级预防是必要的。本文拟对近年公布的糖尿病患者缺血性卒中一级和二级预防的相关证据进行概述,使临床医师了解该领域的研究现状与动态,从而更好地实施糖尿病患者的卒中预防措施。
Diabetes can more than double the risk of ischemic stroke and long-term poor prognosis in diabetic patients with ischemic stroke. The current strong hypoglycemic treatment does not benefit diabetics from primary and secondary prevention of ischemic stroke. However, studies have shown that targeted management of risk factors for ischemic stroke, in particular interventions for adverse lifestyles, blood glucose, hypertension, and lipid metabolism disorders, can prevent and improve the incidence of ischemic stroke in diabetic patients Prognosis. Antithrombotic therapy and carotid surgery are essential for primary and secondary prevention of ischemic stroke among eligible diabetic patients. This article intends to summarize the evidence about the primary and secondary prevention of ischemic stroke in diabetic patients published in recent years, so that clinicians can understand the research status and dynamics in this field so as to better implement the stroke prevention measures in diabetic patients.