α-硫辛酸治疗T2DM伴急性脑梗死疗效及对胰岛β细胞功能和神经功能的影响

Efficacy of α-lipoic Acid in Treatment of T2DM with Acute Cerebral Infarction and Its Effects on Islet β Cell Function and Neurological Function

目的:探讨α-硫辛酸治疗2型糖尿病(T2DM)伴急性脑梗死(ACI)疗效及对胰岛β细胞功能和神经功能的影响。方法:140例T2DM伴ACI患者按随机数表分为观察组与对照组各70例。对照组实施胰岛素注射及口服抗凝、降脂、神经修复等常规药物治疗,观察组在常规治疗基础上联合α-硫辛酸进行治疗。比较治疗前及治疗1个月后,两组患者胰岛β细胞功能[胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)]、神经功能、糖代谢[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(Hb A1c)]、炎性因子[超敏C反应蛋白(hsCRP)、白细胞介素-6(IL-6)]水平变化,分析治疗1个月内两组患者药物不良反应发生情况。结果:治疗1个月后,两组HOMA-IR、FPG、2 h PG、Hb A1c、hs-CRP、IL-6水平及NIHSS评分均较治疗前有显著下降,但观察组明显低于同期对照组(P均<0.05);两组HOMA-β均较治疗前有显著提升,但观察组明显高于同期对照组(P均<0.05)。治疗1个月内,两组各项药物不良反应发生率比较均无统计学意义(P均>0.05)。结论:α-硫辛酸治疗T2DM伴ACI对胰岛β细胞功能和神经功能改善效果较为理想,对预后疾病转归有利。

Objective:To explore the efficacy ofα-lipoic acid on type 2 diabetes mellitus(T2DM)with acute cerebral infarction(ACI)and its effects on isletβcell function and neurological function.Methods:One hundred and forty cases cases of T2DM with ACI in our hospital were selected and divided into the observation group(n=70)and the control group(n=70)according to the random number table method.The control group was only given insulin injection and oral anticoagulation,lipid-lowering,nerve repairr and other routine drugs,and the observation group was treated withα-lipoic acid on the basis of routine treatment.The levels of isletβcell function[homeostasis model assessment of insulin resistance(HOMA-IR),and isletβcell function index(HOMA-β)],neurological function,glucose metabolism[fasting plasma glucose(FPG),2 h postprandial blood glucose(2 h PG),glycosylated hemoglobin(HbAlc)],inflammatory factor[high-sensitivity C-reactive protein(hs-CRP),interleukin-6((IL-6)]were compared before treatment and after 1 month of treatment,and the occurrence of adverse drug reactions within 1 month of treatment was analyzed in the two groups.Results:After 1 month of treatment,the levels of HOMA-IR,FPG,2 h PG,HbA1,hs-CRP and IL-6 and the NIHSS score in the two groups were significantly decreased compared with those before treatment,and the levels and score in the observation group were significantly lower than those in the control group(all P<0.05).The HOMA-βscore was significantly increased in both groups,but significantly higher in the observation group than that in the control group(all P<0.05).Within 1 month after treatment,there was no statistically significant difference in the incidence rate of adverse drug reactions between the two groups(all P>0.05).Conclusions:α-lipoic acid for T2DM with ACI has ideal improvement effects on the isletβcell function and neurological function,and it is helpful to the prognosis and recovery of the disease.