·糖尿病大血管病·

　　【摘要】 目的 探讨脑梗死合并糖尿病患者血清高敏反应蛋白(hsC-RP)和同型半胱氨酸(Hcy)的水平变化及其临床意义。 方法 选取脑梗死合并糖尿病患者(A组)55例、单纯脑梗死患者(B组)53例及单纯T2DM者(C组)55例，分别检测各组入院时和治疗4周后hsC-RP、Hcy水平。另根据A组入院时Hcy和hsC-RP水平分为Hcy<22 μmmol/L亚组28例、Hcy≥22 μmol/L亚组27例，hsC-RP<21 mg/L亚组24例及hsC-RP≥21 mg/L亚组31例，比较预后结局情况。 结果 (1)治疗前、后，A组Hcy、hsC-RP水平均高于B组和C组(P<0.05)，但B组与C组比较差异无统计学意义(P>0.05)。与治疗前比较，治疗后各组Hcy、hsC-RP水平均下降(P<0.05);(2)Hcy<22 μmmol/L亚组不良结局发生率低于Hcy≥22 mmol/L亚组[4(0.14) vs 11(0.41)，χ2=4.850，P=0.028];hsC-RP<21 mg/L亚组不良结局发生率低于hsC-RP≥21 mg/L亚组[4(0.17) vs 14(0.45)，χ2=4.989，P=0.026]。 结论 脑梗死合并糖尿病患者hsC-RP和Hcy水平高于脑梗死和糖尿病患者，且与预后密切相关。

　　【关键词】 高敏反应蛋白;同型半胱氨酸;脑梗死合并糖尿病

　　【Abstra】 Objective To investigate the change of hypersensitivity C protein(hsC-RP) and homocysteine(Hcy) in cerebral infarction patients with diabetes mellitus and its clinical significance. Methods Subjects in this study included 55 cerebral infarction patients with T2DM (Group A), 53 cerebral infarction patients without T2DM (Group B) and 55 T2DM without cerebral infarction (Group C). HsC-RP and Hcy levels were tested at admission and 4 weeks after the treatment. The group A were divided into four subgroups according to the levels of Hcy and hsC-RP: Hcy<22 μmmol/L subgroup(n=28), Hcy≥22 μmol/L subgroup(n=27), hsC-RP<21 mg/L subgroup(n=24) and hsC-RP≥21 mg/L(n=31). The prognostic outcomes of subjects in each group were evaluated and compared. Results (1) Whether before or after treatment, the levels of Hcy and hsC-RP were higher in group A than in group B and group C, but there were no significantly differences between group B and group C(P>0.05). Hcy and hsC-RP levels were decreased in each group after treatment(P<0.05). The incidence of adverse outcomes was lower in Hcy<22 mmol/L subgroup than in Hcy≥22 mmol/L subgroup [4(0.14) vs 11(0.41)，χ2=4.850，P=0.028]; The incidence of adverse outcomes was lower in hsC-RP<21 mg/L subgroup than in hsC-RP≥21 mg/L subgroup[4(0.17) vs 14(0.45)，χ2=4.989，P=0.026]. Conclusion hsC-RP and Hcy levels were higher in cerebral infarction patients with diabetes than in patients separately with cerebral infarction or diabetes, and were closely related to the prognosis.

　　【Key words】 High sensitivity C-reactive protein(HsC-RP); Homocysteine(Hcy); Diabetes; Cerebral infarction