河北医学
河北醫學
하북의학
HEBEI MEDICINE
2015年
3期
374-377
,共4页
2型糖尿病%胰岛素抵抗%缺血性脑卒中%神经功能缺损
2型糖尿病%胰島素牴抗%缺血性腦卒中%神經功能缺損
2형당뇨병%이도소저항%결혈성뇌졸중%신경공능결손
Type 2 diabetes mellitus%Insulin resistance%Ischemic stroke%Neurological deficit
目的：探讨2型糖尿病（T2DM）并发缺血性脑卒中（IS）患者胰岛素抵抗（IR）水平与神经功能损害及预后的关系。方法：选择60例T2DM合并IS患者纳入观察组，未合并IS的T2DM患者50例设为对照组，计算所有患者胰岛素敏感指数（ISI），比较观察组与对照组ISI水平。根据ISI情况将观察组患者分为轻型胰岛素抵抗组（n＝38）和重型胰岛素抵抗组（n＝22），比较两组患者神经功能缺损程度评分（ CNFDS）、日常生活能力评分（ ADL）、临床疗效及并发症情况。结果：观察组患者ISI平均为－4．48±0．53，明显低于对照的－3．71±0．54，差异有统计学意义（ P＜0．05）；重型IR组治疗总有效率明显低于轻型IR组，并发症发生率明显高于轻型IR组，差异均有统计学意义（P＜0．05）；轻型IR组CNFDS明显低于重型IR组，ADL评分明显高于重型IR组，差异有统计学意义（ P＜0．05）；Pearson相关分析显示观察组IR水平与CNFDS呈正相关性（P＜0．05）。结论：胰岛素抵抗程度与2型糖尿病并发缺血性脑卒中密切相关，且可影响脑卒中后患者神经功能损害程度及预后。
目的：探討2型糖尿病（T2DM）併髮缺血性腦卒中（IS）患者胰島素牴抗（IR）水平與神經功能損害及預後的關繫。方法：選擇60例T2DM閤併IS患者納入觀察組，未閤併IS的T2DM患者50例設為對照組，計算所有患者胰島素敏感指數（ISI），比較觀察組與對照組ISI水平。根據ISI情況將觀察組患者分為輕型胰島素牴抗組（n＝38）和重型胰島素牴抗組（n＝22），比較兩組患者神經功能缺損程度評分（ CNFDS）、日常生活能力評分（ ADL）、臨床療效及併髮癥情況。結果：觀察組患者ISI平均為－4．48±0．53，明顯低于對照的－3．71±0．54，差異有統計學意義（ P＜0．05）；重型IR組治療總有效率明顯低于輕型IR組，併髮癥髮生率明顯高于輕型IR組，差異均有統計學意義（P＜0．05）；輕型IR組CNFDS明顯低于重型IR組，ADL評分明顯高于重型IR組，差異有統計學意義（ P＜0．05）；Pearson相關分析顯示觀察組IR水平與CNFDS呈正相關性（P＜0．05）。結論：胰島素牴抗程度與2型糖尿病併髮缺血性腦卒中密切相關，且可影響腦卒中後患者神經功能損害程度及預後。
목적：탐토2형당뇨병（T2DM）병발결혈성뇌졸중（IS）환자이도소저항（IR）수평여신경공능손해급예후적관계。방법：선택60례T2DM합병IS환자납입관찰조，미합병IS적T2DM환자50례설위대조조，계산소유환자이도소민감지수（ISI），비교관찰조여대조조ISI수평。근거ISI정황장관찰조환자분위경형이도소저항조（n＝38）화중형이도소저항조（n＝22），비교량조환자신경공능결손정도평분（ CNFDS）、일상생활능력평분（ ADL）、림상료효급병발증정황。결과：관찰조환자ISI평균위－4．48±0．53，명현저우대조적－3．71±0．54，차이유통계학의의（ P＜0．05）；중형IR조치료총유효솔명현저우경형IR조，병발증발생솔명현고우경형IR조，차이균유통계학의의（P＜0．05）；경형IR조CNFDS명현저우중형IR조，ADL평분명현고우중형IR조，차이유통계학의의（ P＜0．05）；Pearson상관분석현시관찰조IR수평여CNFDS정정상관성（P＜0．05）。결론：이도소저항정도여2형당뇨병병발결혈성뇌졸중밀절상관，차가영향뇌졸중후환자신경공능손해정도급예후。
Objective:To investigate the relationship of insulin resistance ( IR) with neurological dam-age and prognosis in patients with type 2 diabetes mellitus ( T2DM) and ischemic stroke ( IS) .Method:60 patients with T2DM and IS were included into the observation group , 50 T2DM patients without IS were in-cluded into the control group , insulin sensitivity index ( ISI ) were detected and compared .Patients with T2DM and IS were divided into light IR(LIR) group(n =38) and severe IR(SIR) group (n =22),neu-rologic impairment score ( CNFDS ) , activities of daily living ( ADL ) , clinical efficacy and complications were compared .Result:The ISI in observation group was -4 .48±0.53, and it was significantly lower than the the control group, which was -3.71±0.54(P<0.05); the total efficiency in LIR group was significantly lower and complication rate was significantly higher than that in SIR group ( P<0.05);the CNFD score was significantly lower and ADL score was significantly higher in LIR group than that in SIR group , the difference was statistically significant (P<0.05).Pearson correlation analysis showed that the level of IR in observation group was positively correlated with CNFDS (P <0.05).Conclusion:The level of IR in T2DM is closely re-lated to the occur of IS, and related to the degree of neurological damage and prognosis in post -stroke pa-tients.
