老年2型糖尿病合并急性脑梗死患者血清脂联素水平的变化及意义

发布时间：2018-01-27 10:30

本文关键词： 型糖尿病脑梗死脂联素炎性因子颈动脉内膜中层厚度　出处：《山东医药》2016年01期 　论文类型：期刊论文

【摘要】：目的探讨老年2型糖尿病合并急性脑梗死患者脂联素(APN)水平的变化及意义。方法正常对照组30例(A组)、2型糖尿病未合并脑梗死组30例(B组)及2型糖尿病合并急性脑梗死组66例(C组),测定各组超敏C反应蛋白(hs-CRP)、生化指标、糖化血红蛋白(Hb A1c)、空腹胰岛素(FINS)、同型半胱氨酸(Hcy)、TNF-α,采用ELISA法测定血清脂联素(APN)、可溶性细胞黏附因子-1(s ICAM-1)、可溶性血管间黏附分子-1(s VCAM-1)水平,超声测定颈动脉内膜中层厚度(IMT)及斑块情况,比较各组上述指标间的差异,并进行相关分析。结果 A、B、C组的APN水平依次降低,hs-CRP、IMT、TNF-α、s VCAM-1、s ICAM-1及Hcy依次增高,三组间比较差异有统计学意义(P均0.05)。APN与FPG、FINS、HOMA-IR、hs-CRP、IMT、TNF-α、s VCAM-1均呈负相关(r分别为-0.382、-0.413、-0.423、-0.538、-0.503、-0.319、-0.364,P均0.01),与s ICAM-1及Hcy呈负相关(r分别为-0.279、-0.260,P均0.05)。结论老年2型糖尿病合并急性脑梗死患者血清APN水平降低,其可能通过升高炎性因子及Hcy水平而参与患者的动脉粥样硬化进程。
[Abstract]:Objective to investigate the changes and significance of adiponectin (APN) levels in elderly patients with type 2 diabetes mellitus complicated with acute cerebral infarction. Thirty patients with type 2 diabetes mellitus without cerebral infarction (group B) and 66 patients with type 2 diabetes mellitus with acute cerebral infarction (group C) were used to determine the hypersensitive C-reactive protein (hs-CRP) and biochemical indexes. Serum adiponectin (APN) was determined by ELISA method. The levels of soluble cell adhesion factor-1, ICAM-1 and soluble intervascular adhesion molecule-1 (VCAM-1) were observed. Carotid intima-media thickness (IMT) and plaques were measured by ultrasound. The differences among the above indexes were compared and the correlation analysis was carried out. Results the APN level in group A was decreased in turn. The ICAM-1 and Hcy of hs-CRP IMTN TNF- 伪 and VCAM-1s increased in turn. The differences among the three groups were statistically significant (P < 0.05). APN was significantly different from that of FINS (HOMA-IRMA-CRP) IMTNF- 伪. S VCAM-1 showed negative correlation (r = -0.382) -0.413 ~ (-1) -0.423 ~ (-1) -0.538 ~ (-1) -0.503 ~ (-1) -0.319 ~ (-1) ~ (-0.364) respectively. P both 0.01, and negatively correlated with s ICAM-1 and Hcy, r = -0.279 ~ -0.260, respectively. Conclusion the serum APN level in the elderly patients with type 2 diabetes mellitus complicated with acute cerebral infarction is decreased, which may participate in the process of atherosclerosis by increasing the levels of inflammatory factors and Hcy.
【作者单位】：连云港市第一人民医院;
【分类号】：R587.1;R743.3
【正文快照】： 脂联素(APN)具有抗炎、抗动脉硬化、调节糖代谢、脂代谢、增加胰岛素敏感性等多种作用[1,2]。故APN已成为糖尿病及其大血管病变的研究热点,但目前研究多集中在糖尿病并发冠心病中,而对于糖尿病并发急性脑梗死的作用及作用机制研究相对少。本研究拟通过观察老年2型糖尿病(T2DM)

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