老年者糖尿病と脳血管障害
1971 年 14 巻 6 号 p. 345-351
詳細
1971 年 14 巻 6 号 p. 345-351
Vascular complication, especially CVD, is the most serious problem in diabetes mellitus of old persons in Japan. Because of lack of ample data in this field, we attempted to find clinical as well as pathological features of complicating CVD in diabetes. For the purpose of this study, 25 male and 26 female diabetic subjects were selected at random from the autopsied series at the Yokufukai Geriatric Hospital as well as 30 non-diabetic male and 98 non-diabetic female subjects who served as controls. The mean age and its standard deviation was almost the same in each group.
1. Vascular lesions were classified into three types according to their size, location, and clinical manifestation: large or fatal, medium-sized or non-fatal with clinical manifestations and small without clinical signs. Fatal cerebral hemorrhage was observed exclusively in the non-diabetic female patients. Incidence of medium-sized and small hemorrhage was almost the same in the diabetic and non-diabetic groups.
2. Fatal cerebral infarction was almost equally found in the diabetic and non-diabetic persons. The incidence of medium-sized, small, or multiple infarction was significantly higher in the diabetic than in the non-diabetic group.
3. Of normotensive subjects, cerebral hemorrhage was more common in the diabetic than in the non- diabetic. In hypertensive subjects, fatal hemorrhage was significantly more frequent in the non-diabetic.
4. Medium-sized, small, or multiple infarction was significantly more frequent in the hypertensive diabetic than in the hypertensive non-diabetic patients. In normotensive cases, the incidence of these types of infarction was found equally in the diabetic and in the non-diabetic. The incidence of severe cerebral atherosclerosos and medium-sized, small or multiple infarctions was highest in these subjects having a combination of diabetes, hypertension, and hypercholesterolemia.
5. Incidence of hemiplegia, pseudobulbar palsy, and/or dementia, was significantly higher in the diabetic than in the non-diabetic. Motor restoration of CVD patients with diabetes was significantly poorer than that of the non-diabetic persons.
