抗氧化治疗对2型糖尿病合并急性脑梗死患者RBP4及糖脂代谢的影响

Effect of Antioxidant Therapy on the Levels of Retinol Binding Protein 4 and Glucose-lipidmetabolism in Patients with Type 2 Diabetic Complicated with Acute Cerebral Infarction

目的:探讨抗氧化治疗对2型糖尿病合并急性脑梗死患者血清视黄醇结合蛋白4(RBP4)及糖脂代谢的影响。方法:选取2013年6月-2015年6月在临沂市河东区人民医院住院的2型糖尿病合并急性脑梗死患者110例,将患者随机分为治疗组56例和对照组54例。患者均行生活方式干预,给予降糖、调脂、降压、抗血小板凝聚、改善循环药物治疗。在此基础上治疗组将α-硫辛酸注射液600 mg加入250 m L 0.9%氯化钠溶液中静脉滴注,1次/d,连用3周,对照组予以维生素C治疗。观察治疗前后两组的RBP4、胱抑素C(Cys-C)、半胱氨酸(Hcy)、高敏C反应蛋白(hs-CRP)、血糖(FPG、2 h PG、Hb A1c)、血脂(TG、TC、LDL-C、FFA)、β细胞功能(HOMA-IR、HOMA-β)、血压、体重指数、心电图、肝肾功能、电解质以及NIHSS评分等方面的变化,并记录药物不良反应。结果:两组治疗后的RBP4、Cys-C、Hcy、hs-CRP水平、FPG、2 h PG、Hb A1c、HOMA-IR、TG、TC、LDL-C、FFA较治疗前均下降,HOMA-β均升高,其中治疗组变化更明显,治疗组下降幅度与对照组比较差异均有统计学意义(P<0.01);两组治疗后的NIHSS评分较治疗前均下降,治疗组下降更显著,差异有统计学意义(P<0.01);两组未发现明显不良反应。结论:抗氧化剂α-硫辛酸治疗2型糖尿病合并急性脑梗死,可明显降低患者RBP4和血糖、血脂水平,改善胰岛β细胞功能,并可降低NIHSS评分。

Objective：To research the efficacy of antioxidant therapy on the levels of retinol binding protein 4 and glucose-lipid metabolism in patients with type 2 diabetic complicated（T2DM） with acute cerebral infarction（ACI）.Method：110 patients with T2 DM complicated with acute cerebral infarction were randomized into two groups. Patients were treated with life style intervention,blood sugar, lipid, blood pressure, anti platelet aggregation and improved circulation drugs.On this basis, 56 cases of the treatment group were given alpha-lipoic acid 600 mg and 250 m L 0.9% sodium chloride solution,1 time/d,3 weeks;the control group was treated with vitamin C.The levels of RBP4,Cys-C,Hcy,hs-CRP,blood glucose（FPG、2 h PG、Hb A1c）, blood lipid,blood pressure and body weight were measured and the score of NIHSS was evaluated before and after the treatment.Result：After one course of treatment,the levels of RBP4,Cys-C,Hcy,hs-CRP,FPG,2 h PG,Hb A1 c,TG,TC,HOMA-IR were decreased of two groups,the treatment group was better than the control group,the differences were statistically significant（P0.01）. After treatment, the NIHSS score of the two groups were decreased, and the treatment group was significantly lower than that of the control group,the difference was statistically significant（P0.01）; the two groups were not found significant adverse reaction.Conclusion：The treatment of type 2 diabetes with acute cerebral infarction, which can significantly reduce RBP4 and blood glucose, blood lipid level, improve the function of islet beta cells and can reduce the NIHSS score.