目的 比较国际糖尿病联盟(IDF,2005年)、美国国家胆固醇教育计划成人治疗指南(NCEP-ATPⅢ)修订版(NCEP-ATPⅢ修订版,2005年)和《中国成人血脂异常防治指南》(血脂指南,2007年)3种代谢综合征诊断标准在脑卒中高危人群中的应用.方法 选择脑卒中高危患者,比较3种标准的诊断差异,并比较不同诊断标准下有无代谢综合征(MS)与颈动脉粥样硬化的关系.结果 应用IDF、NECP-ATPⅢ修订版和“血脂指南”标准,MS患病率分别为61.7％、72.4％和58.9％;MS组颈动脉内中膜增厚(54.3％对50.3％、55.0％对46.8％、57.0％对46.6％,均P＜0.05)及斑块(44.9％对38.7％、45.2％对35.7％、47.8％对35.0％、均P＜0.05)的检出率均显著高于非MS组;随着MS组分数的增加,颈动脉内中膜增厚及斑块检出率逐渐增加(均P＜0.01);3种诊断标准的MS使颈动脉粥样硬化的风险均增强.结论 MS能增加颈动脉粥样硬化患病率,在预测颈动脉内中膜增厚时以NECP-ATPⅢ修订版标准突出,而预测颈动脉斑块时以“血脂指南”标准突出.%Objective To compare 3 types of diagnostic criteria for metabolic syndrome (MS) in patients with high risk of stroke.Three types of criteria were proposed by (1) International Diabetes Federation (IDF),(2) The revised National Cholesterol Education Program-Adult Treatment Panel Ⅲ (NCEP-ATP Ⅲ-R),and (3) " Guideline of Dyslipidemia Control for Chinese Adult" (" Guideline").Methods A total 4 206 patients with high risk of stroke were enrolled in the study.Diagnosis of MS was made according to three different criteria,and carotid atherosclerosis was evaluated in the patients with or without MS.Results The prevalences of MS according to the IDF,NCEP-ATP Ⅲ-R,and " Guideline" were 61.7％,72.4％,and 58.9％ respectively.The incidence of thickened carotid intimamedia(54.3％ vs 50.3％,55.0％ vs 46.8％,57.0％ vs 46.6％,all P＜0.05) and carotid atherosclerotic plaques (44.9％ vs 38.7％,45.2％ vs 35.7％,47.8％ vs 35.0％,all P＜0.05) was significantly higher in MS patients than non-MS ones.As the number of MS components increased,the incidence of carotid atherosclerosis rised significantly (all P＜0.01).Conclusions MS is related to raised incidence of carotid atherosclerosis.NCEP-ATP Ⅲ-R seems more suitable in detecting thickened carotid intima-media layer.While " Guideline" is better in predicting carotid atherosclerotic plaques.
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