甲钴胺注射液治疗2型糖尿病并发脑梗死患者的临床疗效观察  

Investigation of Clinical Efficacy and Mechanism of Methylcobalamin Injection in the Treatment of Type 2 Diabetes Mellitus Patients with Cerebral Infarction

作　　者：黄文清[1] 范小艳[1] 刘景辉[1] 陈惠琼[1] 

机构地区：[1]广东佛山市第一人民医院康复科,佛山市528000

出　　处：《中国药房》2011年第8期695-697,共3页China Pharmacy

摘　　要：目的:观察甲钴胺注射液治疗2型糖尿病并发脑梗死急性期患者的临床疗效。方法:选取2型糖尿病并发脑梗死急性期的患者共78例,随机分为治疗组和对照组,2组患者均常规给予抗血小板聚集、改善脑循环、神经营养等药物,并根据病情及神经功能缺损情况予以早期康复治疗。治疗组加用甲钴胺注射液2000μg·d-1,静脉滴注,qd,疗程为4周。2组患者治疗前、后应用欧洲卒中量表(ESS)评估神经功能,Barthel指数评估日常生活活动能力(ADL),并测定血浆同型半胱氨酸(Hcy)水平。结果:治疗前2组患者ESS评分、Barthel指数、Hcy值均无显著性差异;治疗4周后比较,2组患者ESS及Barthel指数值均较治疗前有显著增高(P<0.05),且治疗组患者明显高于对照组(P<0.05);2组Hcy水平则均较治疗前显著下降(P<0.05),且治疗组效果更明显(P<0.05)。结论:甲钴胺注射液治疗可有效改善2型糖尿病并发脑梗死急性期患者的临床预后。OBJECTIVE： To study the clinical efficacy and mechanism of Methylcobalamin injection for type 2 diabetes melli- tus patients with cerebral infarction. METHODS： 78 type 2 diabetes mellitus patients with cerebral infarction were randomly divid- ed into Methylcobalamin injection therapy group and control group. Both groups were given conventional treatment, such as an- ti-platelet aggregation, cerebral circulation improvement and neurotrophy. Early rehabilitation therapy was given according to illness condition and neurological impairment. Therapy group received intravenous injection of Methylcobalamin injection （2 000 μg·d-1） once a day for 4 weeks. Before and after treatment, neurological function and activities of daily living （ADL） were evaluated by ESS and Barthel index. The level of Hcy in plasma was also determined. RESULTS： There was no significant difference in ESS score, Barthel index and Hcy level in 2 groups before treatment. After 4 week treatment, ESS score and Barthel index in 2 groups increased significantly （P〈0.05）, and that of Methylcobalamin injection therapy group was significantly higher than that of control group （P^0.05）. The Hcy levels in plasma decreased significantly in both groups after treatment （P^0.05）, but that of Methylco- balamin injection therapy group was significantly lower than that of control group （P^0.05）. CONCLUSION： Methylcobalamin in- jection therapy can improve clinical prognosis in type 2 diabetes mellitus patients with acute cerebral infarction, which maybe related with the decrease of Hcy level in plasma.

关 键 词：糖尿病 脑梗死 同型半胱氨酸 甲钴胺 

分 类 号：R969[医药卫生—药理学] R74[医药卫生—药学]