老年2型糖尿病合并脑梗死患者血清脂联素、超敏C反应蛋白及颈动脉内膜中层厚度的变化

The changes of adiponectin,high-sensitivity C-reactive protein and intima media thickness in the elderly with type 2 diabetes mellitus and cerebral infarction

目的探讨老年2型糖尿病(T2DM)合并脑梗死患者血清脂联素(APN)、超敏C反应蛋白(hs-CRP)及颈动脉内膜中层厚度(IMT)的变化。方法测定正常对照组30例(A组)、T2DM非脑梗死组30例(B组)及T2DM合并脑梗死组33例(C组)的血糖、血脂、肝肾功能、糖化血红蛋白(HbA1c)、hs-CRP,ELISA法测定血清APN水平,超声测定IMT;分析组间差异。结果与A组相比,B、C组hs-CRP、IMT均升高,C组升高更明显(P<0.05);A、B、C三组血清APN水平依次降低(P<0.05);APN水平与hs-CRP和IMT均呈负相关(r=-0.528、r=-0.585,P<0.05)。结论T2DM合并脑梗死患者动脉炎性反应引起动脉粥样硬化更加明显;联合检测血清APN、hs-CRP及IMT,对T2DM患者合并脑梗死可能有预测和辅助诊断作用。

Objective To investigate the changes of adiponectin,high-sensitivity C-reactive protein（hs-CRP） and intima media thickness（IMT） in the elderly with type 2 diabetes mellitus（T2DM） and cerebral infarction.Methods Blood glucose（BG）,blood fat,liver and renal function,glycosylated hemoglobin（HbA1c） and hs-CRP were examined in 30 normal controls（group A）,30 T2DM patients without cerebral infarction（group B） and 33 T2DM patients with cerebral infarction（group C）.Serum adiponectin（APN） was determined by ELISA.The carotid atherosclerosis plaque and IMT were detected by Dopplar ultrasound examination.The differences among three groups were analyzed.Results Compared to group A,hs-CRP and IMT were higher in groups of B and C（P0.05）.Serum APN level of three groups was in an order of group A group B group C（P0.05）.Serum APN level was negatively correlated to hs-CRP and IMT（r=-0.528 and r=-0.585）（P0.05）.Conclusion The severity of carotid atherosclerosis induced by inflammatory reaction is more in T2DM patients with cerebral infarction than that in those without.Combined detection of adiponectin,hs-CRP and IMT is helpful in the diagnosis and evaluation of prognosis in T2DM patients with cerebral infarction.