Kardiyoembolik olmayan iskemik inmeli hastalarda metabolik sendromun inme rekürrensi ve prognozu üstüne olan etkileri
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Date
2011
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Trakya Üniversitesi Tıp Fakültesi
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info:eu-repo/semantics/openAccess
Abstract
İnme, dünya toplumlarında kalp hastalıkları ve kanserden sonra üçüncü ölüm nedeni olup, sakatlık ve özürlülük yapan en önemli hastalıktır. Primer önleme özellikle önemlidir, çünkü vakaların %70'i ilk olaydır (169). Etkili önleyici yaklaşımlar ile yaşa spesifik insidansı son 20 yıl içinde %40 azaltılmıştır. Metabolik sendrom ile kardiyovasküler hastalıklar arasındaki ilişkiye dair çok sayıda çalışma olmasına karşın, metabolik sendrom ile serebro vasküler hastalık arasındaki ilişkiye dair çok az çalışma bulunmaktadır. Metabolik sendrom tanısı için dünya sağlık örgütü tanı kriterleri kullanıldı. Genetik ve çevresel faktörler sonucu meydana geldiği düşünülen metabolik sendrom'un fizyopatolojisinin temelini insülin direnci ve yağ dokusu bozuklukları oluşturmaktadır. Metabolik sendrom'un karakteristik özellikleri abdominal obezite, kan basıncı yükselmesi, glukoz intoleransı ve aterojenik dislipidemi olarak tanımlanmıştır. Ayrıca protrombotik ve proinflamatuar bir süreç olarak ifade edilmiştir. Biz bu çalışmada kardiyoembolik olmayan iskemik inmeli hastalarda metabolik sendrom'un inme rekürrensi ve prognozu üstüne olan etkilerini incelemeyi amaçladık. Trakya Üniversitesi Tıp Fakültesi Nöroloji Anabilim Dalı'nda gerçekleştirilen bu çalışmaya toplam 132 hasta alındı. Bu 132 hastanın 47(%35.6)' sı kadın, 85(%64.4)'i erkek olup,cinsiyetten bağımsız olarak bütün vakaların yaş ortalaması 64.92±11.6'dür. Diabetus mellitus ve glukoz tolerans bozukluğu olan hastaların toplamı diabet tanısı almış olarak değerlendirildiğinde ve insülin rezistansı olanlarda 6 aylık izlem sonrası prognozların daha kötü ve rekurenslerin daha sık olduğu bulundu (p<0.05). Metabolik sendromu olan hastaların, modifiye rankin skoru ve National Institute of Hskoruyla skorların 6 aylık izlem sonrası daha yüksek olarak bulundu (p<0.05). Metabolik sendrom görülme oranları hastalarda Metabolik sendrom sıklığı 90 (%68.2) olarak bulundu. Bu çalışmanın sonucunda, metabolik sendrom ile iskemik serebrovasküler hastalıklar arasında anlamlı bir ilişki bulunamadı. Ancak Metabolik sendrom'un alt parametreleri olan Diabetes mellitus ve insulin rezistansı ile inme prognozu ve inme rekurensi arasında anlamlı bir ilişki saptanmıştır
Abstract
Stroke is the third leading cause of death worldwide after heart disease and cancer,and the number one cause of disability and handicap.Primary prevention is especially important because 70% of the cases are first occurences(169).With effective preventive measures taken,age-specific incidence has been reduced by 40% in the last 20 years. Despite the fact that many studies have been carried out on the relationship between and cardiovascular diseases,only a few studies on the relationship between metabolic syndrome and cardiovascular diseases are available. metabolic syndrome was diagnosed using the World Health Organization diagnosis criteria. Genetic and environmental factors are thought to be the causes of metabolic syndrome whose physiopathology is related to insulin resistance and disorders of the fatty tissue.The characteristic features of metabolic syndrome are abdominal obesity,high blood pressure, glucose intolerance and atherogenic dislipidemy. metabolic syndrome has also been defined as a prothrombic and proinflammatory process.The objective of this study was to investigate the effects of metabolic syndrome on stroke recurrence and prognosis in patients with non-cardioembolic ischemic stroke.This study was conducted at the Neurology Department of the Faculty of Medicine Trakya University and 132 patients were included.Of the 132 patients 47 (35.6%) were female and 85 (%64.4%) male;regardless of gender the mean age of all patients was 64.92±11.6 years.After 6 months of follow-up, prognosis was found to be worse and reccurences more frequent in patients with Diabetes mellutes (all patients with Diabetes mellutes and glucose resistance were regarded as Diabetes mellutes patients) and insulin resistance (p<0,05). Modifiye Rankin scores and National Institute of Hskoruyla scores were found to be higher in metabolic syndrome patients after the 6-month follow-up (p<0,05). metabolic syndrome was observed in 90 patients (68.2%).In this study no significant correlation was found between metabolic syndrome and ischemic cerebrovascular diseases.However,a significant correlation was found between the sub-parameters of metabolic syndrome (Diabetes mellutes and insulin resistance) and, the prognosis and recurrence of stroke.
Abstract
Stroke is the third leading cause of death worldwide after heart disease and cancer,and the number one cause of disability and handicap.Primary prevention is especially important because 70% of the cases are first occurences(169).With effective preventive measures taken,age-specific incidence has been reduced by 40% in the last 20 years. Despite the fact that many studies have been carried out on the relationship between and cardiovascular diseases,only a few studies on the relationship between metabolic syndrome and cardiovascular diseases are available. metabolic syndrome was diagnosed using the World Health Organization diagnosis criteria. Genetic and environmental factors are thought to be the causes of metabolic syndrome whose physiopathology is related to insulin resistance and disorders of the fatty tissue.The characteristic features of metabolic syndrome are abdominal obesity,high blood pressure, glucose intolerance and atherogenic dislipidemy. metabolic syndrome has also been defined as a prothrombic and proinflammatory process.The objective of this study was to investigate the effects of metabolic syndrome on stroke recurrence and prognosis in patients with non-cardioembolic ischemic stroke.This study was conducted at the Neurology Department of the Faculty of Medicine Trakya University and 132 patients were included.Of the 132 patients 47 (35.6%) were female and 85 (%64.4%) male;regardless of gender the mean age of all patients was 64.92±11.6 years.After 6 months of follow-up, prognosis was found to be worse and reccurences more frequent in patients with Diabetes mellutes (all patients with Diabetes mellutes and glucose resistance were regarded as Diabetes mellutes patients) and insulin resistance (p<0,05). Modifiye Rankin scores and National Institute of Hskoruyla scores were found to be higher in metabolic syndrome patients after the 6-month follow-up (p<0,05). metabolic syndrome was observed in 90 patients (68.2%).In this study no significant correlation was found between metabolic syndrome and ischemic cerebrovascular diseases.However,a significant correlation was found between the sub-parameters of metabolic syndrome (Diabetes mellutes and insulin resistance) and, the prognosis and recurrence of stroke.
Description
Tıpta Uzmanlık Tezi
Keywords
Serebrovasküler Hastalık, Prognoz, Rekurens, Metabolik Sendrom, Cerebrovascular Disease, Reccurence, Metabolik Syndrome, Prognosis
