脑梗死合并糖尿病患者高敏C反应蛋白及同型半胱氨酸的水平变化及其临床意义

The changes of serum hypersensitivity C reactive protein and homocysteine in cerebral infarction patients with diabetes mellitus and their clinical significances

目的探讨脑梗死合并糖尿病患者血清高敏C反应蛋白(hsC-RP)和同型半胱氨酸(Hcy)的水平变化及其临床意义。方法选取脑梗死合并糖尿病患者(A组)55例、单纯脑梗死患者(B组)53例及单纯T2DM者(C组)55例,分别检测各组入院时和治疗4周后hsC-RP及Hcy水平。另根据A组入院时Hcy和hsC-RP水平分为Hcy<22μmol/L亚组28例、Hcy≥22μmol/L亚组27例;hsC-RP<21mg/L亚组24例、hsC-RP≥21mg/L亚组31例,比较预后结局情况。结果 (1)治疗前后,A组Hcy和hsC-RP水平均高于B组和C组(P<0.05),但B组与C组比较差异无统计学意义(P>0.05)。与治疗前相比,治疗后各组Hcy和hsC-RP水平均下降(P<0.05);(2)Hcy<22μmol/L亚组不良结局发生率低于Hcy≥22μmol/L亚组[4(0.14)vs 11(0.41),χ2=4.850,P=0.028];hsC-RP<21mg/L亚组不良结局发生率低于hsC-RP≥21mg/L亚组[4(0.17)vs 14(0.45),χ2=4.989,P=0.026]。结论脑梗死合并糖尿病患者hsC-RP和Hcy水平高于单纯脑梗死和糖尿病患者,且与预后密切相关。

Objective To investigate the changes of serum hypersensitivity C reactive protein（hs （2- RP） and homocysteine （Hcy） in cerebral infarction patients with diabetes mellitus and the clinical significances. Methods Subjects in this study included 55 cerebral infarction patients with T2DM （Group A）, 53 cerebral infarction patients without T2DM （Group B） and 55 T2DM without cerebral infarction （Group C）. HsC-RP and Hcy levels were tested at admission and 4 weeks after the treatment. The group A were divided into four subgroups according to the levels of Hcy and hsC-RP.. Hcy 〈22 μmol/L subgroup（n= 28）, Hcy≥22/,mol/L subgroup（n= 27）, hsC-RP〈21 mg/L subgroup（n= 24） and hsC-RP≥21 mg/L（n= 31）. The prognostic outcomes of subjects in each group were evaluated and compared. Results Before or after treatment, the levels of Hcy and hsC-RP were higher in group A than in group B and group C, but there were no significantly differences between group B and group C（P〉 0.05）. Hcy and hsC-RP levels were decreased in each group after treatment（P〈0.05）. The incidence of adverse outcomes was lower in Hcy〈22 mmol/L subgroup than in Hcy〈22 mmol/L subgroup [4（0.14） vs 11（0.41） ,X2 =4. 850,P=0. 0281 ; The incidence of adverse outcomes was lower in hsC-RP〈21 mg/L subgroup than in hsC-RP≥21 mg/L subgroup[4（0. 17） vs 14（0. 45） ,）X2 =4. 989,P=0. 026]. Conclusion hsC-RP and Hcy levels were higher in cerebral infarction patients with diabetes than in patients separately with cerebral infarction or diabetes, and were closely related to the prognosis.