2型糖尿病肾病微炎症反应与急性脑梗死关系的研究  

Study on the relationship between reaction of microinflammation in type 2 diabetic nephropathy and acute cerebral infarction

作　　者：黄劬[1] 刘殿阁[2] 宋文娟[1] 郭兆凌[1] 

机构地区：[1]南京市市级机关医院肾内科,江苏南京210018 [2]东南大学附属中大医院肾内科,江苏南京210009

出　　处：《现代医学》2010年第6期603-606,共4页Modern Medical Journal

摘　　要：目的:检测2型糖尿病肾病(DN)合并急性脑梗死患者血清超敏-C反应蛋白(hs-CRP)水平,并探讨DN微炎症反应与急性脑梗死发生的关系。方法:选取2006年1月至2009年6月在我院住院的急性脑梗死患者96例,观察患者尿白蛋白排泄率(UAER)、hs-CRP、神经功能缺损评分(NIHSS)等指标,并根据UAER检测结果将2型糖尿病(T2DM)患者分为正常蛋白尿组(NA)、微量白蛋白尿组(MA)及临床白蛋白尿组(CP)。结果:本组96例急性脑梗死患者中合并T2DM占58.33%(56/96)。患者hs-CRP T2DM组明显高于非T2DM组,差异有统计学意义(P<0.01)。T2DM组各组间及与非T2DM组比较,NA与非T2DM组间hs-CRP水平无显著性差异。NA与MA及非T2DM组患者hs-CRP比较差异均有统计学意义(P<0.01);CP与MA相比,hs-CRP水平有显著性差异(P<0.01)。NIHSS T2DM组明显高于非T2DM组(P<0.01),并且死亡率T2DM组明显高于非T2DM组,差异有显著性统计学意义(P<0.01)。hs-CRP阳性组死亡率明显高于hs-CRP阴性组,差异有统计学意义(P<0.01)。结论:急性脑梗死合并DN患者普遍存在微炎症反应,这可能影响急性脑梗死患者病情及其预后。hs-CRP或许可作为预测DN合并急性脑梗死患者病情程度及预后的重要指标。Objective： To investigate the changes of the serum level of highly sensitive C-reactive protein（hs-CRP） in type 2 diabetic nephropathy（DN） patients complicated by acute cerebral infarction and to explore the relationship of reaction of microinflammation in DN and ischemic stroke.Methods： Totally 96 acute cerebral infarction patients who were hospitalized in our hospital from January 2006 to June 2009 were included in this study.Urinary albumin excretion rate（UAER）,hs-CRP,scores of the Nation Institute of Health Stroke Scale（NIHSS） and other related factors were investigated.According to the results of UAER,cases of type 2 diabetes mellitus（T2DM） were divided into normal albumin urinary（NA） group,micro albumin urinary（MA） group,and clinical albumin（CP） group.Results： In the 96 cases,T2DM accounted for 58.33%（56/96）.The serum level of hs-CRP in the patients with T2DM was significantly higher than that in non-T2DM（P0.01）.There was not significant difference in serum hs-CRP level between group NA,MA,CP and non-T2DM group.Between group NA and MA,non-T2DM,the differences were noted（P0.01）.Meanwhile,there was also significant difference in serum hs-CPR of CP compared with that of MA（P0.01）.Scores of NIHSS was significantly higher in T2DM group than in non-T2DM patients（P0.01）.Furthermore,the rate of death in T2DM patients more increased than in non-T2DM group（P0.01）.Moreover,the rate of death in hs-CRP positive group significantly increased than that in hs-CRP negative group（P0.01）.Conclusion： Acute cerebral infarction with DN exist reaction of microinflammation normally,which may have influence on the state of acute cerebral infarction and it＇s prognosis.The hs-CRP level of patients with DN complicated acute cerebral infarction might predict patient＇s condition and prognosis.

关 键 词：2型糖尿病肾病 急性脑梗死 微炎症反应 超敏C-反应蛋白 

分 类 号：R692.3[医药卫生—泌尿科学] R743.3[医药卫生—外科学]