血清同型半胱氨酸、脂联素、高敏C反应蛋白水平与颈动脉内膜中层厚度在老年2型糖尿病合并脑梗死患者中的意义

目的：观察血清同型半胱氨酸（Hcy）、脂联素（APN）、高敏C反应蛋白（hs．CRP）水平与颈动脉内膜中层厚度（1MT）在老年2型糖尿病合并脑梗死患者中的意义。方法：选择2008年5月至2012年5月在我院就诊的2型糖尿病患者218例，按照是否合并脑梗死分为糖尿病伴脑梗死组（105例）和单纯糖尿病组（113例）。选择同期健康体检者30例为健康对照组。观察三组血清Hcy、APN、hs—CRP和IMT的水平变化。结果：糖尿病伴脑梗死组和单纯糖尿病组的血清Hcy、hs—CRP和IMT的水平均较正常对照组明显提高（P〈0．01），糖尿病伴脑梗死组以上指标显著高于单纯糖尿病组（P〈0．01）；而糖尿病伴脑梗死组和单纯糖尿病组的血清APN的水平较正常对照组明显降低（P〈0．01），糖尿病伴脑梗死组血清APN的水平较单纯糖尿病组显著降低（P〈0．01）。血清Hcy和hs—CRP水平随着1MT的严重程度增加而升高（P〈0．01），而APN水平随着IMT严重程度升高而降低（P〈0．01）。结论：糖尿病伴脑梗死的患者大血管病变较单纯糖尿病患者更为严重，颈动脉IMT与Hcy和hs—cRP呈正相关，而与APN呈负相关。

Significance of Serum Homocysteine,Adiponectin, High-sensitivity C-reactive Protein Levels and Carotid Intima-media Thickness in Elderly Type 2 Diabetes Patients with Cerebral Infarction

Objective： To observe the significance of serum homocysteine （Hcy）, adiponectin （APN）, high-sensitivity C-reactive protein （hs-CRP） levels and carotid intima-media thickness （IMT） in elderly type 2 diabetes patients with cerebral infarction. Methods： 218 patients with type 2 diabetes admitted in our hospital from May 2008 to May 2012 were selected and randomly divided into diabetes combined with cerebral infarction group （DM with CI group, 105 cases） and DM group （113 cases）. 30 healthy persons during the same period were selected as healthy control group. The serum levels of Hcy, APN and hs-CRP as well as IMT were observed and compared among three groups. Results： The serum levels of Hcy, hs-CRP and IMT in DM with CI group and DM group were increased significantly compared with the control group （P〈0.01）, which were obviously higher in DM with CI group than those in DM group （P〈0. 01）; while the serum levels of APN in DM with CI group and DM group were both significantly lower than those in the control group （P〈0.01）, which were obviously lower than those in the DM group （P〈0.01）. As the severity oflMT increased, the serum levels of Hcy and hs-CRP decreased （P〈0.01）, while, the levels of APN decreased significantly （P〈0.01）. Conclusion： Type 2 diabetes patients with cerebral infarction have more serious macrovascular complication than those only with diabetes, the carotid IMT was positively correlated with serum levels of Hcy and hs-CRP and negatively correlated with serum APN level.