血清同型半胱氨酸、C反应蛋白与2型糖尿病伴脑梗死患者颈动脉粥样硬化的关系
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摘要
目的探讨血清同型半胱氨酸(Hcy)、C反应蛋白(CRP)与2型糖尿病伴脑梗死患者颈动脉粥样硬化之间的关系。方法选择2015年1月～2018年1月在广西科技大学第二附属医院(以下简称"我院")进行治疗的2型糖尿病伴脑梗死患者100例纳入糖尿病伴脑梗死组,选取同期在我院进行治疗的单纯2型糖尿病患者100例纳入单纯糖尿病组,另选取同期在我院行体检的健康者50名为对照组。对三组受试者的Hcy、CRP、颈动脉内膜中层厚度(IMT)、空腹血糖(FPG)、餐后2 h血糖(2 h PBG)进行检测比较,并对Hcy、CRP与IMT、FPG、2 h PBG相关性进行检验分析。结果糖尿病伴脑梗死组Hcy、CRP、IMT、FPG、2 h PBG各指标水平均高于单纯糖尿病组,且糖尿病伴脑梗死组与单纯糖尿病组以上各指标均高于对照组(P <0.05)。糖尿病伴脑梗死组内,随着患者的IMT增大,患者的Hcy、CRP、FPG、2 h PBG依次增加,组间比较差异有统计学意义(P <0.05)。糖尿病伴脑梗死组患者经胰岛素强化治疗后,患者的Hcy、CRP、IMT、FPG、2 h PBG水平均较治疗前明显下降(P <0.05)。Pearson相关性分析结果显示,Hcy、CRP与IMT、FPG、2 h PBG呈正相关(P <0.05)。结论 2型糖尿病伴脑梗死患者的颈动脉粥样硬化斑块严重程度高于单纯糖尿病患者,且患者的血清Hcy、CRP水平与患者颈动脉粥样硬化程度呈正相关,可能参与其发生发展过程。
Objective To investigate the relationship between serum homocysteine(Hcy), C-reactive protein(CRP) and carotid atherosclerosis in patients with type 2 diabetes mellitus complicated with cerebral infarction. Methods A total of 100 patients with type 2 diabetes mellitus complicated with cerebral infarction admitted to the Second Affiliated Hospital of Guangxi University of Science and Technology("our hospital" for short) from January 2015 to January 2018 were included in the diabetes mellitus complicated with cerebral infarction group, and 100 patients with simple type 2 diabetes treated in our hospital during the same period were included in the simple diabetes group, and another50 healthy individuals who underwent physical examination in our hospital during the same period were selected as the control group. Hcy, CRP, carotid intima-media thickness(IMT), fasting plasma glucose(FPG) and 2 h postprandial plasma glucose(2 h PBG) were measured and compared in each group. The correlation among Hcy, CRP and IMT, FPG and2 h PBG was analyzed. Results There was a significant difference in Hcy, CRP, IMT, FPG and 2 h PBG between the diabetes mellitus complicated with cerebral infarction group and the simple diabetes group(P < 0.05), and all the indices of the two groups were higher than those in the control group(P < 0.05). In the diabetes mellitus complicated with cerebral infarction group, Hcy, CRP, FPG and 2 h PBG increased as the increase of IMT, and the difference was statistically significant(P < 0.05). After intensive insulin therapy, the levels of Hcy, CRP, IMT, FPG and2 h PBG in diabetes mellitus complicated with cerebral infarction group were significantly lower than those before treatment(P < 0.05). Pearson correlation analysis result showed that Hcy and CRP had positive correlation with IMT, FPG and 2 h PBG(P < 0.05). Conclusion The severity of carotid arteries atherosclerosis plaque in patients with type 2 diabetes mellitus complicated with cerebral infarction is higher than that of patients with simple diabetes, and the level of serum Hcy and CRP is positively correlated with the degree of carotid arteries atherosclerosis, which may be involved in the development process of carotid arteries atherosclerosis.
Objective To investigate the relationship between serum homocysteine(Hcy), C-reactive protein(CRP) and carotid atherosclerosis in patients with type 2 diabetes mellitus complicated with cerebral infarction. Methods A total of 100 patients with type 2 diabetes mellitus complicated with cerebral infarction admitted to the Second Affiliated Hospital of Guangxi University of Science and Technology("our hospital" for short) from January 2015 to January 2018 were included in the diabetes mellitus complicated with cerebral infarction group, and 100 patients with simple type 2 diabetes treated in our hospital during the same period were included in the simple diabetes group, and another50 healthy individuals who underwent physical examination in our hospital during the same period were selected as the control group. Hcy, CRP, carotid intima-media thickness(IMT), fasting plasma glucose(FPG) and 2 h postprandial plasma glucose(2 h PBG) were measured and compared in each group. The correlation among Hcy, CRP and IMT, FPG and2 h PBG was analyzed. Results There was a significant difference in Hcy, CRP, IMT, FPG and 2 h PBG between the diabetes mellitus complicated with cerebral infarction group and the simple diabetes group(P < 0.05), and all the indices of the two groups were higher than those in the control group(P < 0.05). In the diabetes mellitus complicated with cerebral infarction group, Hcy, CRP, FPG and 2 h PBG increased as the increase of IMT, and the difference was statistically significant(P < 0.05). After intensive insulin therapy, the levels of Hcy, CRP, IMT, FPG and2 h PBG in diabetes mellitus complicated with cerebral infarction group were significantly lower than those before treatment(P < 0.05). Pearson correlation analysis result showed that Hcy and CRP had positive correlation with IMT, FPG and 2 h PBG(P < 0.05). Conclusion The severity of carotid arteries atherosclerosis plaque in patients with type 2 diabetes mellitus complicated with cerebral infarction is higher than that of patients with simple diabetes, and the level of serum Hcy and CRP is positively correlated with the degree of carotid arteries atherosclerosis, which may be involved in the development process of carotid arteries atherosclerosis.
引文
[1]方瑾,叶荣苹,黄刚,等.西格列汀对老年2型糖尿病患者颈动脉内膜中层厚度和同型半胱氨酸的影响[J].中华老年心脑血管病杂志,2016,18(11):1140-1143.
[2]沈奇峰.瑞舒伐他汀和阿托伐他汀对老年冠心病患者血脂、超敏C反应蛋白、同型半胱氨酸水平及颈动脉内膜中层厚度的影响[J].中国老年学杂志,2017,37(17):1209-1212.
[3]莫新玲,杨锡恒,谢婷,等.H型高血压合并2型糖尿病患者血浆Hcy、Cyst-C水平与颈动脉内膜中层厚度的关系[J].广东医学,2017,38(6):855-858.
[4]Lv Y,Zhang Y,Shi W,et al.The Association Between Endocan Levels and Subclinical Atherosclerosis in Patients with Type 2 Diabetes Mellitus[J].Am J Med Sci,2017,353(5):433-438.
[5]刘超,郑桃林,杜万红,等.血清胱抑素C水平与中老年人2型糖尿病合并脑梗死的相关性[J].中华保健医学杂志,2016,18(3):193-195.
[6]Pleskovic A,Letonja M,Vujkovac AC,et al.C-reactive protein as a marker of progression of carotid atherosclerosis in subjects with type 2 diabetes mellitus[J].Vasa,2017,46(3):187-192.
[7]刘巧玲,孟洁.老年2型糖尿病合并急性脑梗死患者血清脂联素水平的变化及意义[J].山东医药,2016,34(1):72-74.
[8]王兰芳,王小敏.3项指标联合检测对老年2型糖尿病患者颈动脉粥样硬化的预测价值[J].国际检验医学杂志,2017,38(15):2137-2139.
[9]Pleskoviˇc A,譒antl Letonja M,Cokan VA,et al.SOX6 gene polymorphism(rs16933090)and markers of subclinical atherosclerosis in patients with type 2 diabetes mellitus[J].Int Angiol,2016,35(6):552-556.
[10]孔雪,姚梅琪,史平,等.影响2型糖尿病合并脑梗死病人颈动脉内膜中层厚度相关危险因素的研究进展[J].全科护理,2017,34(35):4395-4397.
[11]Popovic'D,Nikolajevic'SJ,譒antl Letonja M,et al.PECAM-1gene polymorphism(rs668)and subclinical markers of carotid atherosclerosis in patients with type 2 diabetes mellitus[J].Balkan J Med Genet,2016,19(1):63-70.
[12]钟慧婷,傅永平.血清同型半胱氨酸和颈动脉内膜中层厚度在2型糖尿病合并冠状动脉粥样硬性心脏病患者中的临床意义[J].中华危重症医学杂志:电子版,2017,10(4):267-269.
[13]王洋,冯伟华,王家豫.2型糖尿病合并脑梗死与血清同型半胱氨酸的相关性[J].海南医学,2016,27(1):114-115.
[14]陶鹏辉.老年高血压患者血清同型半胱氨酸、超敏C反应蛋白及胱抑素C水平与颈动脉内膜中层厚度的相关性分析[J].新乡医学院学报,2017,34(5):416-418.
[15]陆明雪,刘红伟,吴景华.2型糖尿病合并颈动脉粥样硬化与超敏C反应蛋白及同型半胱氨酸的关系[J].中国临床研究,2015,28(10):1316-1318.下转第页
[16]刘勇,陈锐,王娓娓,等.血清同型半胱氨酸、脂联素、高敏C反应蛋白水平与颈动脉内膜中层厚度在老年2型糖尿病合并脑梗死患者中的意义[J].现代生物医学进展,2014,14(1):96-98.
[17]胡小娟,刘宁,包丽娟.血清Hcy水平与合并2型糖尿病的急性脑梗死相关性分析[J].中国实用神经疾病杂志,2014,17(9):71-72.
[18]金凤,张哲峰,祖艳颖,等.老年脑梗死合并2型糖尿病患者Hcy表达及颈动脉硬化的研究[J].中风与神经疾(上接第129页)病,2017,34(4):361-362.
[19]祁瑞芳.同型半胱氨酸、超敏C-反应蛋白在2型糖尿病合并脑梗死预测中的作用[J].西部中医药,2014,27(4):136-137.
[20]刘国敏,李志红,张学艳,等.2型糖尿病合并急性脑梗死中血清hs-CRP、UA水平以及血液流变学指标的联合诊断评价[J].中国医药导刊,2017,19(1):31-32.
[2]沈奇峰.瑞舒伐他汀和阿托伐他汀对老年冠心病患者血脂、超敏C反应蛋白、同型半胱氨酸水平及颈动脉内膜中层厚度的影响[J].中国老年学杂志,2017,37(17):1209-1212.
[3]莫新玲,杨锡恒,谢婷,等.H型高血压合并2型糖尿病患者血浆Hcy、Cyst-C水平与颈动脉内膜中层厚度的关系[J].广东医学,2017,38(6):855-858.
[4]Lv Y,Zhang Y,Shi W,et al.The Association Between Endocan Levels and Subclinical Atherosclerosis in Patients with Type 2 Diabetes Mellitus[J].Am J Med Sci,2017,353(5):433-438.
[5]刘超,郑桃林,杜万红,等.血清胱抑素C水平与中老年人2型糖尿病合并脑梗死的相关性[J].中华保健医学杂志,2016,18(3):193-195.
[6]Pleskovic A,Letonja M,Vujkovac AC,et al.C-reactive protein as a marker of progression of carotid atherosclerosis in subjects with type 2 diabetes mellitus[J].Vasa,2017,46(3):187-192.
[7]刘巧玲,孟洁.老年2型糖尿病合并急性脑梗死患者血清脂联素水平的变化及意义[J].山东医药,2016,34(1):72-74.
[8]王兰芳,王小敏.3项指标联合检测对老年2型糖尿病患者颈动脉粥样硬化的预测价值[J].国际检验医学杂志,2017,38(15):2137-2139.
[9]Pleskoviˇc A,譒antl Letonja M,Cokan VA,et al.SOX6 gene polymorphism(rs16933090)and markers of subclinical atherosclerosis in patients with type 2 diabetes mellitus[J].Int Angiol,2016,35(6):552-556.
[10]孔雪,姚梅琪,史平,等.影响2型糖尿病合并脑梗死病人颈动脉内膜中层厚度相关危险因素的研究进展[J].全科护理,2017,34(35):4395-4397.
[11]Popovic'D,Nikolajevic'SJ,譒antl Letonja M,et al.PECAM-1gene polymorphism(rs668)and subclinical markers of carotid atherosclerosis in patients with type 2 diabetes mellitus[J].Balkan J Med Genet,2016,19(1):63-70.
[12]钟慧婷,傅永平.血清同型半胱氨酸和颈动脉内膜中层厚度在2型糖尿病合并冠状动脉粥样硬性心脏病患者中的临床意义[J].中华危重症医学杂志:电子版,2017,10(4):267-269.
[13]王洋,冯伟华,王家豫.2型糖尿病合并脑梗死与血清同型半胱氨酸的相关性[J].海南医学,2016,27(1):114-115.
[14]陶鹏辉.老年高血压患者血清同型半胱氨酸、超敏C反应蛋白及胱抑素C水平与颈动脉内膜中层厚度的相关性分析[J].新乡医学院学报,2017,34(5):416-418.
[15]陆明雪,刘红伟,吴景华.2型糖尿病合并颈动脉粥样硬化与超敏C反应蛋白及同型半胱氨酸的关系[J].中国临床研究,2015,28(10):1316-1318.下转第页
[16]刘勇,陈锐,王娓娓,等.血清同型半胱氨酸、脂联素、高敏C反应蛋白水平与颈动脉内膜中层厚度在老年2型糖尿病合并脑梗死患者中的意义[J].现代生物医学进展,2014,14(1):96-98.
[17]胡小娟,刘宁,包丽娟.血清Hcy水平与合并2型糖尿病的急性脑梗死相关性分析[J].中国实用神经疾病杂志,2014,17(9):71-72.
[18]金凤,张哲峰,祖艳颖,等.老年脑梗死合并2型糖尿病患者Hcy表达及颈动脉硬化的研究[J].中风与神经疾(上接第129页)病,2017,34(4):361-362.
[19]祁瑞芳.同型半胱氨酸、超敏C-反应蛋白在2型糖尿病合并脑梗死预测中的作用[J].西部中医药,2014,27(4):136-137.
[20]刘国敏,李志红,张学艳,等.2型糖尿病合并急性脑梗死中血清hs-CRP、UA水平以及血液流变学指标的联合诊断评价[J].中国医药导刊,2017,19(1):31-32.