| Objective: Thrombomodulin(TM) is a specific marker reflecting and measuring the injury of vascular end-othelial cell. After injury of vascular endothelial cell is caused, TM will be released to the bloodstream inthe form of soluble thrombomodulin (sTM), while the plasma sTM level is bound up with the Atherosclero-sis (AS).Type2Diabetes Mellitus (T2DM), Cerebral Infarction(CI), etc. TM also plays a critical role interms of inflammation regulation, fibrinolysis and cell proliferation. This study aims to observe plasma sT-M level in patients of CI with T2DM at the acute phase; evaluate the correlation between the sTM levelsand neurological severity score (NIHSS);explor the correlation between plasma sTM levels and CI withT2DM.Methods:Select60patients are diagnosed with acute CI(ACI),treated in department of neurology in theFirst Affiliated Hospital of Medical College Shihezhi University from December2011to August2012,bymedical history, physical examination and CT or MRI,30cases with typy2diabetes mellitus(T2DMCI) and30cases non-diabetic cerebral infarction(N-T2DMCI),and30cases over the same period with T2DM.-Select30cases without cerebrovascular disease as the control group in the same period,who match in age,sex, and comorbidities. Collect the general information and laboratory tests of all subjects: average age, sex,smoking history,hypertension history,index of body mass index(BIM),fasting blood glucose(FBG), totalcholesterol(TC),triglycerides(TG),low density lipoprotein(LDL), high density lipoprotein(HDL), prothrom-bin time(PT),activated partial thronboplastin time(APTT) and thrombin time(TT),fibrinogen(FIB).Theplasma sTM level of all subjects were detected by enzyme linked immunosorbent assay(ELISA)and theseventies of neurological impairment were assessed by the National Institute of Health Stroke Scalescore(NIHSS) in cases with ACI. Adopt SPSS17.0software for statistical analysis. Measurement data areexpressed as mean±standard deviation (x s),and use one-way ANOVA, Pearson bivariate correlationanalysis. Use the row×column chi-square test analysis count data.Results: The differences among patients in T2DM group, N-T2DMCI group, T2DMCI group and normalgroup in terms of mean age, gender, smoking history, history of hypertension, PT, APTT and TT showedno statistical significance, P>0.05; there were differences for BIM, FBG, TC, TG, LDL, HDL and FIBwere statistically significant (P <0.05). Comparing within the control group, the plasma sTM levels inpatients in T2DM group, N-T2DMCI group and T2DMCI group increased signify-cantly, showingstatistical significance for the difference (P <0.01), yet among which the T2DMCI group presented themost significant increase in plasma sTM levels. Comparison between the patients in T2DMCI group andN-T2DMCI group indicated that the former had a much higher NIHSS scoring, presenting the significantdiffer-rence, P<0.01. The plasma sTM levels were positively correlated to the clinical NIHSS scoring.Conclusion: Comparing the plasma sTM levels in patients in both ACI group and control group, where theACI group is higher than normal group, and is positively correlated to the severity degree of itsneurological function deficit. The sTM levels of T2DMCI group present more significant increase than theN-T2DMCI group, revealing that the neurological dysfunctions of patients with T2DMCI is more significant. Therefore, the plasma sTM levels are predicted to be the cerebral infarction, especially for theevaluation index for early vascular injury of T2DMCI patients, which is conductive to the evaluation ofseverity degree of neurological function deficit of patients with T2DMCI, as well as its outcome. |
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