TCM Syndrome Of Cerebral Infarction With Type 2 Diabetes And The Correlation Of Serum IL-18、PCO、ISI

Objective:Diabetes is the independent risk factor of cerebral infarction. Hyperinsulinemia, oxidative stress and inflammation have been proven that can trigger the occurence of cerebral infarction. Past studies focus on the relationship among diabetes, cerebral infarction,IL-18 andPCO. However, little is known about the relationship between the cerebral infarction with diabetes and IL-18. There is no reports the correlation between the cerebral infarction with type 2 diabetes and PCO. This study collects 100 cases cerebral infarction patients with/without type 2 diabetes (62 cerebral infarction patients with diabetes,38 cerebral infarction patients),20 diabetes patients and 20 healthy people are used as the control. The clinical characteristics of these patients were analyzed and compared. The aim of this study was to discuss the TCM syndrome of Type 2 Diabetes and Cerebral infarction and the correlation of IL-18、PCO、ISI in the patientMethods:In the Department of Neurology of Affiliated Hospital of Yangzhou University Clinical Subei People’s Hospital,62 patients with type 2 diabetes mellitus with cerebralinfarction, 38 patients of cerebral infarction and 20 patients with diabetes mellitus were chosen as study groups, and 20 healthy subjects were chosen as a control group, during the period October 2014-December 2015. At first, enrolled patients were conducted a series of clinical investigation, including general demographic characteristics, medical history, blood pressure, Symptom Complex of TCM (Traditional Chinese Medicine) and NIHSS (National Institutes of Health Stroke Scale), meanwhile serum lipid, blood glucose, carotid intima-media thickness and infarct size were measured with ultrasound, MRI and so on. Secondly, levels of serum insulin, PCO (protein carbonyl) and Iinterleukin-18 from each group were measured using ELISA (Enzyme-linked immune sorbent analysis). Lastly, the correlations of Symptom Complex of TCM with IL-18, PCO or ISI in patients suffered diabetic mellitus with cerebral infarction were investigated.Results:Disease categorization according to TCM syndromes showed 21 cases of Qi-deficiency and blood-stasis type,18 cases of sputum type,11 cases of wind and fire disturbance type and 12 cases of ytn deficiency wind stirring type, with more patients of Qi-deficiency and blood-stasis type and sputum type among the categories. Compared with patients suffered cerebral infarction with no complications, the illness of patients suffered T2DM combined with cerebral infarction was serious, with greater infarct size range (p<0.05), higher infarction lesions (p< 0.05) and more vascular unstable plaque (p<0.05). More recurrent cerebral infarction were found in patients suffered T2DM combined with cerebral infarction. The levels of serum lipid and blood glucose were higher in the group of T2DM with cerebral infarction than the other groups, but with no statistical difference. The patients of T2DM combined with cerebral infarction were detected higher levels of INS, IL-18 and PCO using ELISA than the patients of cerebral infarction, T2DM or healthy subjects (p<0.05). NIHSS analyses showed that IL-18, PCO and ISI were positively correlated with neurological deficits (p<0.05). ANOVA showed that IL-18 was positively correlated with types of Qi-deficiency and blood-stasis and sputum in patients of T2DM combined with cerebral infarction (P<0.05).Conclusion:Qi-deficiency and blood-stasis type and sputum type were the main types in TCM syndrome differentiation and typing of T2DM with cerebral infarction. The patients of type 2 diabetes mellitus with cerebral infarction suffered high risk of relapse, the illness was more serious, the infarct size range was greater, the infarction lesions and vascular unstable plaque were more. The levels of IL-18、INS、PCO were significantly elevated in the serum of patients suffered T2DM combined with cerebral infarction. In the study, we expected to provide a promising molecular diagnostic method for the patients of T2DM with cerebral infarction.In this study, we analyze the TCM syndrome differentiation and typing of T2DM with cerebral infarction, general demographic characteristics and clinical examination indexes, explore the correlation of those factors with T2DM with cerebral infarction, determinate the high risk factor of the disease. Therapeutic strategies include plaque stabilization by timely anti-inflammatory, antioxidant, improvement of insulin sensitivity, improvement of prognosis. Theoretical basis was provided in the article for the prophylaxis and treatment of T2DM with cerebral infarction by Integrative Medicine as well.