依达拉奉对急性脑梗死合并胰岛素抵抗患者的疗效观察  

Therapeutic effect of edaravone in acute cerebral infarction patients with insulin resistance

作　　者：郑佳[1] 陈旭[1] 

机构地区：[1]上海市第八人民医院神经内科,200235

出　　处：《中华老年心脑血管病杂志》2013年第10期1015-1017,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨依达拉奉对急性脑梗死合并胰岛素抵抗(IR)患者的神经功能缺损程度及IR水平的影响。方法收集急性脑梗死合并IR患者226例,随机分为治疗组113例和对照组113例。治疗组基础治疗+依达拉奉,对照组仅接受基础治疗。采用美国国立卫生研究院卒中量表(NIHSS)评估患者神经功能缺损程度,Barthel指数(BI)评价患者日常生活活动能力。空腹血糖用葡萄糖氧化酶法检测,空腹胰岛素(FINS)用化学发光法检测,计算稳态模型胰岛素抵抗指数(HOMA-IR)。结果与治疗前比较,治疗组治疗第7、14天NIHSS评分、FINS、HOMA-IR(除治疗第7天)明显降低,BI评分明显升高(P<0.05,P<0.01),对照组治疗第14天NIHSS评分明显降低,BI评分明显升高(P<0.05,P<0.01)。与治疗组比较,对照组治疗第14天FINS、HOMA-IR明显升高(P<0.01)。2组治疗前后空腹血糖及不良反应差异无统计学意义(P>0.05)。结论依达拉奉可能改善急性脑梗死合并IR患者的神经功能缺损程度和降低患者的IR水平。Objective To study the effect of edaravone on neural function impairment and insulin resistance （IR） level in acute cerebral infarction patients with IR. Methods Two hundred and twenty six acute cerebral infarction patients with IR were randomly divided into treatment group （n= 113） and control group （n=113）. Patients in treatment group received basic treatment＋edar- avone administration and those in control group accepted only basic treatment. Their neural func- tion impairment and daily living ability were assessed according to the NIHSS and Barthel index （BI） ,respectively. Their fasting blood glucose and insulin levels were measured by glucose oxi- dase and chemiluminescence, respectively. HOMA insulin sensitivity index （HOMA-IR） was cal- culated. Results The NIHSS score,fasting insulin level and HOMA-IR were significantly lower whereas the BI score was significantly higher in treatment group on days 7 and 14 after treatment than before treatment （P〈0.05 ,P〈0.01）. The NIHSS score was significantly lower whereas the BI score was significantly higher in control group on day 14 after treatment than before treatment （P〈0.05 ,P〈0.01）. The fasting insulin level and HOMA-IR were significantly higher in control group than in treatment group on day 14 after treatment. No significant difference was found in fasting blood glucose level and adverse reactions between the two groups before and after treat- ment （P〈0.05）. Conclusion Edaravone can improve the neural function impairment and decrease the IR level in acute cerebral infarction patients with IR.

关 键 词：脑梗死 胰岛素抗药性 高胰岛素血症 血糖指数 自由基清除剂 

分 类 号：R743.33[医药卫生—神经病学与精神病学]