2型糖尿病合并急性脑梗死TCD微栓子监测及炎性因子检测的意义  

Significance of Transcranial Doppler microemboli monitoring,High-sensitivity C Reactive Protein and Interleukin-6 detection in acute cerebral infarction with diabetes

作　　者：陆首玲[1] 梅志忠[2] 李龙宣[3] 彭兰芬[4] 

机构地区：[1]广东医学院附属厚街医院急诊科 [2]广东医学院附属厚街医院神经科,广东523945 [3]广东医学院附属医院神经内科,湛江524001 [4]广东医学院附属厚街医院检验科,广东523945

出　　处：《中国组织化学与细胞化学杂志》2013年第4期306-310,共5页Chinese Journal of Histochemistry and Cytochemistry

摘　　要：目的探讨TCD微栓子(MES)监测及超敏C反应蛋白和白介素-6检测在2型糖尿病合并急性脑梗死发病中的意义。方法序贯收集2011年1月至2012年6月在我院神经内科住院的首次前循环脑梗死患者90例,根据是否合并2型糖尿病分为糖尿病合并脑梗死组(观察组)45例,单纯急性脑梗死组45例(脑梗死组),另外,随机收集同期我院内分泌科首次住院的单纯2型糖尿病患者45例(糖尿病组),监测三组患者病灶侧大脑中动脉(MCA)微栓子阳性率及微栓子数目,血清超敏C反应蛋白及白介素-6值,分析三组患者中微栓子及相关炎性因子检测的意义。结果观察组脑血管微栓子监测数量和Hs-CRP血清检测水平较脑梗死组和糖尿病组均显著增高(P<0.05和P<0.01)。观察组和脑梗死组血清白介素-6检测水平与糖尿病组相比显著增高(P<0.05),但观察组与脑梗死组相比无统计学意义(P>0.05)。结论糖尿病合并急性脑梗死患者微栓子数目和血清Hs-CRP、白介素-6水平明显增高,提示糖尿病脑梗死患者血管内炎性斑块不稳定程度增加,再发卒中的风险明显增高。Objective To Investigate the significance of TCD microemboli signals(MES) monitoring,high-sensitivity C reactive Protein(Hs-CRP) and interleukin-6(IL-6) detection in patients of acute cerebral infarction with diabetes. Methods 90 cases of anterior circulation acute cerebral infarct at Department of Neurology in our hospital from Jan 2011 to Jun 2012 were consecutively allocated to two groups: acute cerebral infarction with diabetes(observation group,n=45) and simple acute cerebral infarction(cerebral infarction group,n=45).Over the same period,45 patients with simple type 2 Diabetes mellitus at Department of Endocrinology in our hospital were randomly collected as controls(diabetic group,n=45).The number and the prevalence of MES from the ipsilateral middle cerebral artery(MCA) were monitored by TCD,the level of Hs-CRP was detected using immunoturbidimetry,and IL-6 was detected by microparticle chemiluminescent immunoassay. Results The numbers of MES in the observation group were significantly higher than those of the cerebral infarction group(P<0.05) and the diabetic group(P<0.01).As compared to the diabetic group and the cerebral infarction group,a significant increase of the serum Hs-CRP level was found in the observation group(P<0.05).And the serum IL-6 level in the observation group and the cerebral infarction group were both significantly higher than that of the diabetic group(P<0.05),while there was no statistical difference between the observation group and the cerebral infarction group(P>0.05). Conclusion Patients of acute cerebral infarction with diabetes have an increased number of MES and higher serumHs-CRP level.It indicates that acute cerebral infarction patients with diabetes have increased inflammatory plaque instability and a greater risk of recurrence.

关 键 词：脑梗死 糖尿病 经颅多普勒 超敏C反应蛋白 白介素-6 

分 类 号：R322.811[医药卫生—人体解剖和组织胚胎学]