| Objective1.To research the changes and clinic significance in the level of the plasma homocysteine and SAA(serum amyloid A)in type 2 diabetic acute cerebral infarction patients;2.To observe their correlation in different diabetic cerebral infarction patients and discuss if Hcy influence the injury of blood vessel by SAA;meanwhile observe the influencing of cymene vitamin B12 to Hcy and SAA,and provide more evidence for early clinical preventive therapy.Methods1.Object choiceStrictly choose 124 patients with acute cerebral infarction who were enrolled as treated group from 2008 June to 2009 Feb in our Department of Neurology based on the criterion of bringing and excluding.2.Group divisible design2.1 Patients were divided into 2 groups based on their anamnesis if they got 2TDM.We recorded patients' gender,age,blood pressure at time of admission,performed head MRI,and evaluated their Neurological Impairment Degree Score(NDS).All patients were required to fast in the next morning after admission and their blood samples were collected to evaluate biochemical indicator including HCY,SAA,TG,TC,and FBS(fasting blood glucose).patients with exceptional HCY were randomly divided into 2 groups:conventional therapy group(intensive blood glucose and blood pressure and blood fat controls and improve brain blood supply and brain nerve nourishment)and experiment therapy group(on the same basal treatment,the experiment therapy group were treated with mecobalamin for 2 weeks: 500ug,every time,daily,intramuscular).And after 2 week's treatment,Hcy,SAA and CRP were checked again.And their NDS were evaluated as well as after 2 week's treatment.2.2 All diabetes mellitus patients with abnormal Hcy were divided into light abnormity group(＜30 umol/L)and heavy abnormity group(≥30 umol/L).3.Statistics analysisTo make statistic analysis by SPSS13.0 stat soft,significant levelα=0.05,data was expressed by mean±standard deviation,multiple groups means were compared with multiple factor analysis of variance,intervention trial result take paired t-test.Results1 Type 2 diabetic acute cerebral infarction patients group than non-diabetic patients group age of onset is light,the difference has statistical significance(P＜0.05).It tipped that diabetic patients with acute cerebral infarction than non-diabetic happened earlier.2.DM group of FPG,HbA1c,Hcy,SAA,Ⅳand NDS rates are significantly higher than NON- DM group;the difference had statistical significance(P＜0.05).3.Within diabetes cerebral infarction group,Hcy and SAA have linear correlation(r= 0.618,P＜0.001)。Generally,there is a difference among the NDS and infarct volume level of the three subgroups.NDS of DM cerebral infarction patients increases with increasing Hcy level; And Hcy＞30umol/L group of infarct volume is greater than Hcy＜15umol/L Group and it also had statistical significance(P=0.016).4.Diabetes cerebral infarction group and non-diabetic cerebral infarction group's area of infarction composition,as well as the area of infarction composition among the various subgroups of DM cerebral infarction patients,the difference was not significant(P＞0.05).5.Diabetic cerebral infarction patients with abnormal Hcy were randomly given treatment, Changes of Hcy,NDS and SAA levels had statistical significance in mecobalamine group; there is no significant change for Hcy level in normal group after treatment(P＞0.05);NDS and Hcy level of normal group have some decline after treatment(p＜0.001).Because of random pre-intervention NDS score and SAA level was balance between the two groups,and further selection of paired t-test to compare the interpolation of NDS and SAA between the normal group and mecobalamine group after treatment and found that the difference between the two groups has statistical significance(t=2.878,p＜0.01;t=2.122,p＜0.05)。Conclusion1.The age of cerebral infarction for Diabetic patients is younger and the illness is more serious also.2.The serious degree of cerebral infarction for Diabetic patients Hcy≥30umol/L is more heavy than the cerebral infracted patients Hcy＜15umol/L。3.By the intervention treatment,"as a reflection of T2DM patients with carotid atherosclerosis in the degree of serological indicators"SAA With the decline in plasma Hcy levels have decreased significantly,inferred SAA may be involved in the Hcy-induced diabetes mellitus patients with cerebral atherosclerosis happen.Clinical Hcy can be combined with SAA levels in diabetic patients with acute cerebral infarction to assess the severity of the disease.4.Mecobalamin is able to decrease the Hcy level for Diabetic cerebral infracted patients, improve SAA level and NDS.To some extent,it is mean to improve the prognosis for patients. |
PDF Full Text Request