|
Purpose. Study of plasma homocysteine ??(Hcy), serum amyloid A (SAA) in acute cerebral infarction patients with type 2 diabetes (T2DM) and its clinical significance; 2 observed Hcy in the severity of the disease type 2 diabetes mellitus (T2DM) patients with acute cerebral infarction in the relationship with SAA explore the SAA is involved in vascular injury Hhcy diabetes and acute cerebral infarction patients; methyl vitamin B12 was observed at the same time the influence of Hcy and SAA, for early clinical therapeutic intervention to provide more evidence. Materials and Methods. Selecting objects strict inclusion and exclusion criteria, select the Shanxi Provincial People's Hospital, Department of Neurology, June 2008 - February 2009 inpatient diagnosis and treatment of 124 cases of acute cerebral infarction. Packet Design 2.1 based on past medical history of the patients are suffering from type 2 diabetes, the patients were divided into diabetic cerebral infarction group, non-diabetic cerebral infarction group, the general situation of the patients with acute cerebral infarction were recorded, the simultaneous determination of plasma Hcy level of SAA. All patients had onset of symptoms within 48 hours brain MRI, neurological score at the same time. Groups Hcy> 15 umol / L patients were randomly divided into two subgroups, the conventional group, the conventional control blood sugar, blood lipids, blood pressure, improve cerebral circulation, nutrition brain; mecobalamin group in addition to conventional therapy plus with A cobalamin, 500ug / day, intramuscular injection, two weeks after were measured Hcy, SAA, and neurological score again. 2.2 In accordance with Hcy levels in patients with diabetic cerebral infarction group is divided into Sanya groups: A (Hcy ≥ 30umol / L), B group (30umol / L> of Hcy ≥ 15 umol / L) the C group Hcy <15 umol / L). 3. Statistical analysis the application SPSS 13.0 statistical software for statistical analysis, inspection level α = 0.05. Count data to the number of cases that constitute two overall than comparison x ~ 2 test; measurement data for normal examination, expressed as mean ± standard deviation, bivariate correlation analysis by linear correlation analysis, two groups were compared using the t test multivariate analysis of variance was used to compare multiple sets, to interfere with the test results using a paired t-test. Results 1 diabetic cerebral infarction patients than non-diabetic cerebral infarction patients age is light, the difference was statistically significant (P <0.05). Tip diabetes to occur earlier than non-diabetic patients with acute cerebral infarction. 2, diabetes, cerebral infarction group fasting plasma glucose (FPG), glycosylated hemoglobin (HbAlc), 2h postprandial blood glucose, homocysteine ??(Hcy), serum amyloid A (SAA), infarct volume (IV), neurological score (NDS) are higher than the non-diabetic cerebral infarction group, the difference was statistically significant (P <0.05). Diabetic cerebral infarction group of Hcy with SAA positive linear correlation (r = 0.618, P <0.001). Neurological score and infarct volume level between the three subgroups, there is a difference. With the elevated Hcy levels, diabetes buck ⒎ ⒓ death reading to blame K à cheek knock level of popliteal DS ratings have also risen;, of Hcy> 30umol / L group infarct volume greater than Hcy <15umol / L group, with statistical significance (P = 0.016). 4, diabetes, cerebral infarction group and non-diabetic patients with cerebral infarction group infarction, and diabetic cerebral infarction group the infarction site constitutes between various subgroups of patients, the difference was not statistically significant (P> 0.05). Hcy ≥ 5 diabetic cerebral infarction group 15umol / L were treated with randomized intervention after treatment, the the Methylcobalamin group Hcy decreased NDS score and SAA levels after treatment, with a statistically significant (P <0.01). Hcy levels in the conventional group after treatment, no significant decline (P> 0.05), NDS score and SAA levels decreased statistically significant (P <0.01). Since the intervention between the two groups before the NDS score and SAA levels balanced random NDS score after treatment, and SAA reduce the situation found both statistically significant differences between the two groups have further selection paired t test was used to compare A cobalt amine group and the conventional group ( t = 2.878, p <0.01; t = 2.122, p <0.05). Conclusion 1, diabetes, cerebral infarction patients compared with non-diabetic patients with cerebral infarction low age, severe illness. 2 of Hcy ≥ 30umol / L diabetes and acute cerebral infarction patients compared with Hcy <15umol / L in patients with severe illness. 3 after mecobalamin therapy \hardening of the occurrence of clinical Hcy and SAA levels can be combined with an assessment of diabetes concurrent disease severity in patients with acute cerebral infarction. 4 mecobalamin can reduce diabetes and acute cerebral infarction patients blood Hcy level, to improve the level of SAA and NDS score, to some extent it makes sense to improve the prognosis of diabetic patients with acute cerebral infarction.
|