脂微球前列地尔治疗ACI合并T2DM疗效及机制研究

Curative effect and mechanism of liposome prostaglandin in treatment of ACI complicated by T2DM

目的研究脂微球前列地尔对急性脑梗死(ACI)合并2型糖尿病(T2DM)患者的临床治疗价值。方法 112例ACI伴T2DM患者随机分为A组和B组,均行常规治疗,A组加用脂微球前列地尔10μg静脉滴注,1次/d,均治疗2 w,比较两组临床疗效和治疗前后神经功能缺损评分、Barthel指数、颈动脉斑块、血管内皮功能和炎症介质水平变化情况。结果 A组治疗总有效率显著高于B组(P<0.05);治疗后,两组神经功能缺损评分显著降低,Barthel指数显著上升,且A组变化幅度大于B组(P<0.05);两组颈动脉血流阻力指数、内-中膜厚度和斑块面积显著下降,斑块稳定性显著上升,血内皮素-1、血栓素B2显著降低,血管内皮细胞生长因子显著上升,可溶性细胞间黏附分子-1、核因子κB(NF-κB)显著下降,且A组变化幅度大于B组(P<0.05)。结论脂微球前列地尔治疗ACI合并T2DM的效果显著,主要与其减轻神经功能缺损,改善颈动脉斑块性质,保护血管内皮功能,减轻炎症反应有关。

Objective To study the clinical value of liposome prostaglandin in the treatment of ACI complicated by T2DM in patients.MeAods A total of 112 patients with ACI complicated by T2DM were randomly divided into tw-o groups,both receiving conventional treatment for two weeks,and on the basis of this,10μg intravenous injection of liposome prostaglandin was additionally performed on Group A once per day.The clinical effects,NIHSS scores before and after the treatment,Barthel indicators,carotid plaque,vascular endothelial function and change in inflammatory^mediator levels were compared between the two groups.Results The total effective rate of treatment of Group A was higher than that of Group<0.05);both groups showed significant decrease in NIHSS scores and great increase in Barthel indicators.In particular,Group A had a wider range than Group B<0.05).For both groups,the carotid artery RI,intima-media thickness and plaque area decreased significantly while the plaque stability improved greatly,plasm endothelin-1 and thromboiane B2 decreased greatly,vascular endothelial cell growth factor increased visibly and soluble intercellular adhesion molecule-1 and nuclear factor kB(NF-kB)decreased greatly.Group A had a wider range than Group B(P<0.05).Condusion Liposome prostaglandin is significantly effective in treating ACI complicated by T2DM,mainly contributing to reducing neurologic impairment,improving carotid plaque performance,protecting vascular endothelium and relieving inflammatory reaction.