红花黄色素对伴应激性高血糖脑梗死患者糖代谢、C-肽水平及凝血功能的影响
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摘要
目的观察红花黄色素对伴应激性高血糖急性脑梗死(ACI)患者糖代谢、C-肽水平及凝血功能的影响。方法前瞻性将达州市中西医结合医院收治的90例伴应激性高血糖的ACI患者随机分为对照组(n=45)和观察组(n=45)。对照组予以常规治疗,观察组在对照组基础上予以红花黄色素治疗,两组疗程均为14 d。对两组临床疗效、NIHSS评分、炎症因子[C反应蛋白(CRP)、单核细胞趋化蛋白1(MCP-1)]、糖代谢指标[空腹血糖(FBG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]、空腹C肽(FCP)、凝血功能[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、D-二聚体]及血液流变学指标进行比较。结果观察组治疗有效率明显高于对照组(91. 11%vs. 73. 33%)(P<0. 05)。治疗后,观察组NIHSS评分及血清CRP、MCP-1、FBG、FINS、HOMA-IR均明显低于对照组(P <0. 05),FCP明显高于对照组(P <0. 05)。治疗后,观察组相比对照组APTT、PT延长(P <0. 05),D-二聚体、血浆黏度及全血高切、低切黏度较低(P <0. 05)。结论红花黄色素治疗伴应激性高血糖的ACI疗效显著,可有效调节糖代谢及C肽水平,改善凝血功能及血液流变学。
Objective To observe the effects of carithamine on glucose metabolism,C-peptide level and blood coagulation function in patients with stress hyperglycemia and acute cerebral infarction( ACI). Methods 90 patients with ACI and stress hyperglycemia were randomly divided into control group( n = 45) and observation group( n = 45). The control group was given routine treatment. On this basis,the observation group was given carithamine. The course of treatment of the two groups were 14 d. The clinical efficacy,NIHSS score,inflammatory factors [C-reactive protein( CRP),monocyte chemoattractant protein 1( MCP-1) ],glucose metabolism indexes [fasting blood glucose( FBG),fasting insulin( FINS),homeostasis model assessment-insulin resistance index( HOMA-IR) ],fasting C-peptide( FCP),blood coagulation function[activated partial thromboplastin time( APTT),prothrombin time( PT),D-dimer]and hemorheology indexes of the two groups were statistically analyzed. Results The response rate of the observation group was significantly higher than that of the control group( 91. 11% vs. 73. 33%)( P< 0. 05). After treatment,the NIHSS scores and serum CRP,MCP-1,FBG,FINS and HOMA-IR in the observation group were significantly lower than those in the control group( P < 0. 05),while the FCP was significantly higher than that in the control group( P < 0. 05). After treatment,the APTT and PT in the observation group were significantly higher than those in the control group( P < 0. 05). The D-dimer,plasma viscosity and whole blood high cut and low cut viscosity were significantly lower than those in the control group( P < 0. 05). Conclusion The efficacy of carithamine is significant for the treatment of ACI with stress hyperglycemia,which can effectively regulate glucose metabolism and C-peptide level,improve blood coagulation function and hemorheology.
Objective To observe the effects of carithamine on glucose metabolism,C-peptide level and blood coagulation function in patients with stress hyperglycemia and acute cerebral infarction( ACI). Methods 90 patients with ACI and stress hyperglycemia were randomly divided into control group( n = 45) and observation group( n = 45). The control group was given routine treatment. On this basis,the observation group was given carithamine. The course of treatment of the two groups were 14 d. The clinical efficacy,NIHSS score,inflammatory factors [C-reactive protein( CRP),monocyte chemoattractant protein 1( MCP-1) ],glucose metabolism indexes [fasting blood glucose( FBG),fasting insulin( FINS),homeostasis model assessment-insulin resistance index( HOMA-IR) ],fasting C-peptide( FCP),blood coagulation function[activated partial thromboplastin time( APTT),prothrombin time( PT),D-dimer]and hemorheology indexes of the two groups were statistically analyzed. Results The response rate of the observation group was significantly higher than that of the control group( 91. 11% vs. 73. 33%)( P< 0. 05). After treatment,the NIHSS scores and serum CRP,MCP-1,FBG,FINS and HOMA-IR in the observation group were significantly lower than those in the control group( P < 0. 05),while the FCP was significantly higher than that in the control group( P < 0. 05). After treatment,the APTT and PT in the observation group were significantly higher than those in the control group( P < 0. 05). The D-dimer,plasma viscosity and whole blood high cut and low cut viscosity were significantly lower than those in the control group( P < 0. 05). Conclusion The efficacy of carithamine is significant for the treatment of ACI with stress hyperglycemia,which can effectively regulate glucose metabolism and C-peptide level,improve blood coagulation function and hemorheology.
引文
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[16]南毛球,戴军,黄光群,等.红花黄色素联合尿激酶对急性脑梗死患者血清MMP-9、S-100B蛋白和NO的影响[J].临床和实验医学杂志,2016,15(19):1878-1880.
[17]郑祖锋,邱毅,季晓东,等.急性脑梗死患者炎性因子与凝血指标的改变及其意义[J].中国卫生检验杂志,2015,25(16):2741-2744.
[18]Li Y,Suo S,Mao L,et al.Acute myocardial/cerebral infarction as first/relapse manifestation in one acute promyelocytic leukemia patient[J].Int J Clin Exp Med,2015,8(8):14210-14213.
[19]刘佳,闫建齐.急性脑梗死患者血浆内皮素及血液流变学指标检测分析[J].解放军预防医学杂志,2015,33(2):187-188.
[20]赵伟,曲芳.血清hs-CRP、UA水平及血液流变学指标联合检测诊断2型糖尿病合并急性脑梗死的意义评价[J].河北医药,2016,38(19):2911-2914.
[2]黄定良,张会香,张裕生,等.糖尿病与应激性高血糖对急性脑梗死患者预后影响研究[J].中国全科医学,2017,20(z2):30-32.
[3]刘青,黄德弘,黄坚红,等.红花黄色素改善急性脑梗死患者脑灌注的临床研究[J].中国新药杂志,2017,26(23):2822-2825.
[4]红花黄色素对糖尿病肾病模型大鼠肾脏细胞血管紧张素Ⅱ1型受体的影响[J].中国组织工程研究,2016,20(18):2677-2683.
[5]中华医学会神经病学分会.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
[6]各类脑血管疾病诊断要点(1995)[J].临床和实验医学杂志,2013,12(7):559.
[7]李莹,王磊沙,刘建勋,等.脑梗死气虚血瘀证大鼠模型表征及病理生理变化研究[J].中国中药杂志,2018,43(4):786-793.
[8]Zhang J,Fang X,Zhou Y,et al.The Possible Damaged Mechanism and the Preventive Effect of Monosialotetrahexosylganglioside in a Rat Model of Cerebral Ischemia-Reperfusion Injury[J].J Stroke Cerebrovasc Dis,2015,24(7):1471-1478.
[9]Tu XK,Yang WZ,Chen JP,et al.Curcumin Inhibits TLR2/4-NF-κB Signaling Pathway and Attenuates Brain Damage in Permanent Focal Cerebral Ischemia in Rats[J].Inflammation,2014,37(5):1544-1551.
[10]房亚兰,黄语悠,赵咏梅,等.大黄酚对局灶性脑缺血再灌注小鼠缺血半暗带区环氧化酶2和基质金属蛋白酶-9表达的影响[J].首都医科大学学报,2017,38(1):47-52.
[11]王昕,刘军,邵芳,等.红花黄色素联合尤瑞克林治疗急性脑梗死的临床观察[J].中国药房,2016,27(14):1955-1957.
[12]贺歆彦,李铁东,付丹飞,等.红花黄色素治疗急性脑梗死疗效观察[J].时珍国医国药,2015,26(4):919-920.
[13]吴腾腾,李明月,邝亚晗,等.胰岛素对脑梗死小鼠梗死周围区血管直径和梗死体积的影响[J].国际脑血管病杂志,2016,24(2):174-179.
[14]马春霞,李学莉,刘辉,等.危重病应激状态下高血糖与胰岛素组份的相关性研究[J].宁夏医学杂志,2016,38(5):408-410.
[15]屈小燕,方爱娟,孙丽君,等.血清空腹C-肽水平与2型糖尿病患者血管病变的关系[J].中国医药导报,2018,15(30):58-61.
[16]南毛球,戴军,黄光群,等.红花黄色素联合尿激酶对急性脑梗死患者血清MMP-9、S-100B蛋白和NO的影响[J].临床和实验医学杂志,2016,15(19):1878-1880.
[17]郑祖锋,邱毅,季晓东,等.急性脑梗死患者炎性因子与凝血指标的改变及其意义[J].中国卫生检验杂志,2015,25(16):2741-2744.
[18]Li Y,Suo S,Mao L,et al.Acute myocardial/cerebral infarction as first/relapse manifestation in one acute promyelocytic leukemia patient[J].Int J Clin Exp Med,2015,8(8):14210-14213.
[19]刘佳,闫建齐.急性脑梗死患者血浆内皮素及血液流变学指标检测分析[J].解放军预防医学杂志,2015,33(2):187-188.
[20]赵伟,曲芳.血清hs-CRP、UA水平及血液流变学指标联合检测诊断2型糖尿病合并急性脑梗死的意义评价[J].河北医药,2016,38(19):2911-2914.