目的 探讨血糖变异性对T2DM（2型糖尿病）并发缺血性脑卒中的影响。方法 一项多中心、回顾性研究。共计纳入2015.1.1-2018.12.31间28家医院的7458例患者。患者按是否发生缺血性脑卒中分：脑卒中组(310例)和非脑卒中组(7148例)。收集患者CV（血糖变异系数）等相关资料。按照CV数值四分位分组患者，CV＜12.55%组1868例、CV为12.55~21.52%组1862例、CV为21.52~32.86%组1867例、CV＞32.86%组1861例。采用Kaplan-Meier法计算缺血性卒中累积发生率，Cox回归分析T2DM并发缺血性脑卒中的影响因素。结果 （1）两组在年龄（69.19±10.59vs58.70±12.21，p<.0001）、HDL-C＜1.0mmol/L（28.39% vs 37.77%，p=0.0008）、高血压史（72.90% vs 37.46%，p<.0001）、心房扑动/颤动史（6.45% vs 1.06%，p<.0001）及CV（26.98±15.53 vs 24.40±15.81，p=0.0048）比较，差异均具有统计学意义。（2）CV四分位后，四组患者缺血性脑卒中的累计发生率分别为3.37%、3.71%、3.86%、5.70%，有显著差异（p=0.0015）。（3）缺血性脑卒中影响因素：CV＞32.86%（HR=1.430，p=0.0294）、高血压史（HR=2.207， p＜0.0001）、心房扑动/颤动（HR= 2.044，p= 0.0043）。结论 高血糖变异性是T2DM并发缺血性脑卒中的风险因素。

Objective To investigate the effect of blood glucose variability on T2DM (type 2 diabetes mellitus) complicated with ischemic stroke. Methods A multicenter, retrospective study. A total of 7458 patients from 31 hospitals from January 1, 2015 to December 31, 2018 were included. According to the incidence of ischemic stroke, the patients were divided into the stroke group (n=310) and the non-stroke group (n=7148). CV (blood glucose coefficient of variation) and other relevant data were collected. According to the CV value, there were 1868 patients in the group with CV < 12.55%, 1862 patients in the group with CV (12.55-21.52%), 1867 patients in the group with CV (21.52-32.86%), and 1861 patients in the group with CV > 32.86%. Kaplan-meier method was used to calculate the cumulative incidence of ischemic stroke, and Cox regression was used to analyze the influencing factors of T2DM complicated ischemic stroke. Results (1) The differences were statistically significant in age (69.19±10.59 vs 58.70±12.21, p<.0001), HDL-c < 1.0mmol/L (28.39% vs 37.77%, p=0.0008), history of hypertension (72.90% vs 37.46%, p<.0001), history of atrial flutter/fibrillation (6.45% vs 1.06%, p<.0001) and CV (26.98±15.53 vs 24.40±15.81, p=0.0048). (2) After CV quartile, the cumulative incidence of ischemic stroke in the four groups was 3.37%, 3.71%, 3.86% and 5.70%, respectively, with significant differences (p=0.0015). (3) Factors influencing ischemic stroke: CV > 32.86% (HR=1.430, p=0.0294), history of hypertension (HR=2.207, p < 0.0001), atrial flutter/fibrillation (HR= 2.044, p= 0.0043).