老年人%类风湿关节炎%脑梗死%脂联素%肿瘤坏死因子α%血清S100B%薯蓣皂甙
老年人%類風濕關節炎%腦梗死%脂聯素%腫瘤壞死因子α%血清S100B%藷蕷皂甙
노년인%류풍습관절염%뇌경사%지련소%종류배사인자α%혈청S100B%서여조대
Elderly%Rheumatoid arthritis%Cerebral infarct%Adiponectin%Tumor necrosis factor-a%Serum100B%Dioscornin
目的 评价薯蓣皂甙对老年类风湿性关节炎合并脑梗死患者体质量指数及血清脂联素、肿瘤坏死因子α和血清S100B浓度的变化及其临床意义.方法 选取2006年9月至2010年9月长治市人民医院神经内科与康复科和绍兴医学院附属医院内科就诊,具有老年类风湿性关节炎合并脑梗死患者100例(男55例,女45例),平均年龄57岁.将100例患者随机分为两组,常规老年类风湿性关节炎组(50例)接受常规药物治疗,薯蓣皂甙组(50例)采用常规药物治疗基础上加用薯蓣皂甙片80 mg,3次/d；另设40例中年单纯性类风湿关节炎患者作为对照(常规对照组),所有患者在治疗前后均常规测定体质量指数、血糖、血脂分析及胰岛素抵抗指数,以及检测血清脂联素、肿瘤坏死因子α和血清S100B浓度变化.结果 薯蓣皂甙组及常规老年类风湿性关节炎组血清脂联素浓度及体质量指数较常规对照组患者明显降低[分别为(7.2±1.4)、(7.3±1.4)、(18.1±3.5)μg/L,F=17.057,P＜0.01;(18.9±2.4)、(19.0±1.9)、(21.8±1.8)kg/m2,F=6.147,P＜0.01]；肿瘤坏死因子α及S100B浓度增加[分别为(89.0±25.3)、(88.0±24.2)、(74.0±21.0) ng/L,F=3.292,P＜0.05; (0.102±0.051)、(0.101±0.045)、(0.092±0.031)μg/L,F=2.792,P＜0.05].血清脂联素与肿瘤坏死因子α及S100B呈负相关(r=-0.46,-0.52；P均＜0.01)；血清脂联素与体质量指数呈正相关(r=0.44,P＜0.01).薯蓣皂甙组治疗6个月分别与常规对照组比较,血清脂联素浓度提高[分别为(12.2±2.9)、(7.8±1.8)、(18.0±4.3) μg/L,F=6.480,P＜0.01],肿瘤坏死因子α及血清S100B浓度明显降低[分别为(72.0±21.0)、(82.0±23.0)、(68.0±20.0) ng/L,F=3.065,P＜0.05; (0.092±0.021)、(0.099±0.031)、(0.091±0.029) μg/L,F=3.030,P＜0.05],而且改善脑梗死患者预后明显优于常规老年类风湿性关节炎组(x2=11.97,P＜0.01).结论 口服薯蓣皂甙片可改善老年类风湿性关节炎合并脑梗死患者预后,提高血清脂联素浓度及显著降低肿瘤坏死因子α及血清S100B浓度,体质量指数也有不同程度的增加.
目的 評價藷蕷皂甙對老年類風濕性關節炎閤併腦梗死患者體質量指數及血清脂聯素、腫瘤壞死因子α和血清S100B濃度的變化及其臨床意義.方法 選取2006年9月至2010年9月長治市人民醫院神經內科與康複科和紹興醫學院附屬醫院內科就診,具有老年類風濕性關節炎閤併腦梗死患者100例(男55例,女45例),平均年齡57歲.將100例患者隨機分為兩組,常規老年類風濕性關節炎組(50例)接受常規藥物治療,藷蕷皂甙組(50例)採用常規藥物治療基礎上加用藷蕷皂甙片80 mg,3次/d；另設40例中年單純性類風濕關節炎患者作為對照(常規對照組),所有患者在治療前後均常規測定體質量指數、血糖、血脂分析及胰島素牴抗指數,以及檢測血清脂聯素、腫瘤壞死因子α和血清S100B濃度變化.結果 藷蕷皂甙組及常規老年類風濕性關節炎組血清脂聯素濃度及體質量指數較常規對照組患者明顯降低[分彆為(7.2±1.4)、(7.3±1.4)、(18.1±3.5)μg/L,F=17.057,P＜0.01;(18.9±2.4)、(19.0±1.9)、(21.8±1.8)kg/m2,F=6.147,P＜0.01]；腫瘤壞死因子α及S100B濃度增加[分彆為(89.0±25.3)、(88.0±24.2)、(74.0±21.0) ng/L,F=3.292,P＜0.05; (0.102±0.051)、(0.101±0.045)、(0.092±0.031)μg/L,F=2.792,P＜0.05].血清脂聯素與腫瘤壞死因子α及S100B呈負相關(r=-0.46,-0.52；P均＜0.01)；血清脂聯素與體質量指數呈正相關(r=0.44,P＜0.01).藷蕷皂甙組治療6箇月分彆與常規對照組比較,血清脂聯素濃度提高[分彆為(12.2±2.9)、(7.8±1.8)、(18.0±4.3) μg/L,F=6.480,P＜0.01],腫瘤壞死因子α及血清S100B濃度明顯降低[分彆為(72.0±21.0)、(82.0±23.0)、(68.0±20.0) ng/L,F=3.065,P＜0.05; (0.092±0.021)、(0.099±0.031)、(0.091±0.029) μg/L,F=3.030,P＜0.05],而且改善腦梗死患者預後明顯優于常規老年類風濕性關節炎組(x2=11.97,P＜0.01).結論 口服藷蕷皂甙片可改善老年類風濕性關節炎閤併腦梗死患者預後,提高血清脂聯素濃度及顯著降低腫瘤壞死因子α及血清S100B濃度,體質量指數也有不同程度的增加.
목적 평개서여조대대노년류풍습성관절염합병뇌경사환자체질량지수급혈청지련소、종류배사인자α화혈청S100B농도적변화급기림상의의.방법 선취2006년9월지2010년9월장치시인민의원신경내과여강복과화소흥의학원부속의원내과취진,구유노년류풍습성관절염합병뇌경사환자100례(남55례,녀45례),평균년령57세.장100례환자수궤분위량조,상규노년류풍습성관절염조(50례)접수상규약물치료,서여조대조(50례)채용상규약물치료기출상가용서여조대편80 mg,3차/d；령설40례중년단순성류풍습관절염환자작위대조(상규대조조),소유환자재치료전후균상규측정체질량지수、혈당、혈지분석급이도소저항지수,이급검측혈청지련소、종류배사인자α화혈청S100B농도변화.결과 서여조대조급상규노년류풍습성관절염조혈청지련소농도급체질량지수교상규대조조환자명현강저[분별위(7.2±1.4)、(7.3±1.4)、(18.1±3.5)μg/L,F=17.057,P＜0.01;(18.9±2.4)、(19.0±1.9)、(21.8±1.8)kg/m2,F=6.147,P＜0.01]；종류배사인자α급S100B농도증가[분별위(89.0±25.3)、(88.0±24.2)、(74.0±21.0) ng/L,F=3.292,P＜0.05; (0.102±0.051)、(0.101±0.045)、(0.092±0.031)μg/L,F=2.792,P＜0.05].혈청지련소여종류배사인자α급S100B정부상관(r=-0.46,-0.52；P균＜0.01)；혈청지련소여체질량지수정정상관(r=0.44,P＜0.01).서여조대조치료6개월분별여상규대조조비교,혈청지련소농도제고[분별위(12.2±2.9)、(7.8±1.8)、(18.0±4.3) μg/L,F=6.480,P＜0.01],종류배사인자α급혈청S100B농도명현강저[분별위(72.0±21.0)、(82.0±23.0)、(68.0±20.0) ng/L,F=3.065,P＜0.05; (0.092±0.021)、(0.099±0.031)、(0.091±0.029) μg/L,F=3.030,P＜0.05],이차개선뇌경사환자예후명현우우상규노년류풍습성관절염조(x2=11.97,P＜0.01).결론 구복서여조대편가개선노년류풍습성관절염합병뇌경사환자예후,제고혈청지련소농도급현저강저종류배사인자α급혈청S100B농도,체질량지수야유불동정도적증가.
Objective To investigate the change of adiponectin (AD),tumor necrosis factor-alpha (TNF-α) and S100 levels in serum elderly patients with rheumatoid arthritis and cerebral infarct in order to evaluate the therapeutic effect of dioscornin.Methods One hundred patients with rheumatoid arthritis and cerebral infarct were selected as our subjects,who were hospitalized in the Department of Neurology of Recovery Changzhi Municipal People's Hospital and the Department of Internal Medicine of the Affiliated Hospital of Shaoxing Medical College,between 2006 September and 2010 September.All subjects (male 55,female 45,average age of 57 years old) were randomly divided into regular and dioscomin groups,50 for per group.Patients in regular group were treated with routine therapy and patients in dioscornin groups were treated with dioscornin 80mg,three daily plus regular treatment drug.Meanwhile 40 middle patients with single rheumatoid arthritis subjects were severed as controls.The changes of BMI,fasting plasma glucose,lipid factors,insulin sensitivity index (ISI),serum adiponectin,TNF-α and serum S100B were determined at treatment before and 6 months after treatments.Results The level of TNF-α,serum S100 in ERA patients were significantly higher andAdiponectin significantly lower than that of the control group,(TNF-α:[(89.0 ± 25.3) ng/L,(88.0 ± 24.2)ng/L vs(74.0 ±21.0) ng/L,F =3.292,P ＜0.05],[S100B:(0.102 ±0.051) μg/L,(0.101 ±0.045) μg/L vs(0.092 ± 0.031) μg/L,F =2.792,P ＜ 0.05],and AD and BMI were lower [AD:(7.2 ± 1.4) μg/L,(7.3 ±1.4) μg/L vs (18.1 ± 3.5) μg/L,F =17.057,P ＜ 0.01],[BMI:(18.9 ± 2.4) kg/m2,(19.0 ± 1.9) kg/m2 vs (21.8 ± 1.8) kg/m2,F =6.147,P ＜ 0.01].There was a negative correlation between adiponect and TNF-α,S100B (r =-0.46,-0.52,P ＜ 0.01) and positive correlation between adiponect and BMI (r =0.44,P ＜0.01).The adiponectin level was significantly increased in patients for six months after dioscornin treatment than that of control group.[AD:(12.2±2.9) μg/L,(7.8 ±1.8) μg/L vs (18.0 ±4.3) μg/L,F=6.480,P＜0.01].The level of TNF-α and S100B significantly decreased than that of the control group,TNF-α:[(72.0 ±21.0) ng/L,(82.0±23.0)ng/L vs (68.0 ±20.0) ng/L,F =3.065,P ＜0.05],[S100B:(0.092 ±0.021)μg/L,(0.099 ±0.031) μg/L vs (0.091 ±0.029) μg/L,F=3.030,P＜0.05].Conclusion Dioscornin could ameliorate the prognosis through decreasing the levels of TNF-α and S100B,and increasing adiponectin level in patients with rheumatoid arthritis and cerebral infarct.
