PAS疗法治疗2型糖尿病合并脑梗死患者的疗效及对血清Hcy和RBP4的影响

Effects of PAS therapy on the serum levels of Hcy and RBP4 in patients with diabetes mellitus complicated with cerebral infarction

目的探讨普罗布考联合阿托伐他汀、阿司匹林(PAS)治疗2型糖尿病合并脑梗死患者的疗效及对血清同型半胱氨酸(Hcy)和视黄醇结合蛋白4(RBP4)的影响。方法选取本院本科于2014年1月至2017年5月期间收治的126例2型糖尿病合并脑梗死患者,用随机数字表法将患者分为对照组与观察组,每组63例,对照组在常规治疗基础上给予阿托伐他汀联合阿司匹林治疗(AS疗法),观察组在对照组基础上联用普罗布考治疗(PAS疗法)。比较两组患者治疗1个月后的临床疗效、神经功能,同时监测治疗前后血清炎症因子、Hcy、RBP4变化情况,统计治疗过程中发生的不良反应。结果两组治疗后的美国国立卫生研究院神经功能缺损(NIHSS)评分均降低,且观察组NIHSS评分明显低于对照组(P<0.05);治疗后,观察组临床治疗有效率为87.3%(55/63),对照组为68.3%(43/63),观察组临床治疗有效率率明显高于对照组(P<0.05);治疗后,两组血清TNF-α、hs-CRP、Hcy、RBP4明显降低(P<0.05),且观察组TNF-α、hs-CRP、Hcy、RBP4水平低于对照组(P<0.05);两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论PAS疗法治疗2型糖尿病合并脑梗死安全有效,能够有效降低血清Hcy和RBP4水平,缓解炎症损伤,改善患者神经功能。

Objective To investigate the effect of probucol+aspirin+atorvastatin(PAS)therapy on the serum levels of homocysteine(Hcy)and retinol binding protein 4(RBP4)in patients with diabetes mellitus complicated with cerebral infarction.Methods 126 cases of cerebral infarction patients complicated with diabetes mellitus in our hospital were recruited during January 2014 to May 2017,and then all of them were randomly divided into control group and observation group,63 cases in each group.The control group was treated with atorvastatin combined with aspirin on the basis of routine treatment(AS therapy),and the observation group received the probucol on that basis of control group(PAS therapy).The clinical efficacy,neurological function,complications,changes of serum inflammatory factors,Hcy and RBP4 were evaluated in both groups before and after treatment.Results After treatment,the National Institute of Health Stroke Scale(NIHSS)score of both groups were decreased and the NIHSS score of the observation group was lower than that in the control group(P<0.05).After treatment,the effective rate of clinical treatment in observation group and control group were respectively 87.3%,68.3%,the effective rate of observation group was significantly higher than control group(P<0.05).After treatment,the serum levels of tumor necrosis factors-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP),Hcy and RBP4 in both groups were decreased significantly(P<0.05);the serum levels of TNF-α,hs-CRP,Hcy and RBP4 in observation group were significantly lower than those in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions PAS therapy is safe and effective in the treatment of type 2 diabetes mellitus complicated with cerebral infarction,which can effectively reduce serum levels of Hcy and RBP4,relieve inflammatory injury and improve neurological function.