高晓艳 谷艳 周萍萍 陈刚 夏彩秋

[摘要] 目的 研究分析急性脑梗死合并2型糖尿病患者同型半胱氨酸水平（Hcy）和预后之间的关联性，给临床治疗提供参考。 方法 于2013年10月—2014年10月该院对急性脑梗死患者84例开展了研究分析，将患者分成糖尿病组和非糖尿病组，糖尿病组有48例患者，非糖尿病组有36例患者，对比分析了两组患者的72 h动态血糖情况，根据两组在治疗前后的脑卒中神经功能缺损评分（CSS）和治疗前的Hcy水平进行了比较分析。 结果 糖尿病组的患者其血清内的Hcy水平平均是（27.97±13.83）μmo1/L，非糖尿病组患者的Hcy水平平均是（19.79±8.64）μmo1/L，两组的Hcy水平对比差异有统计学意义（P<0.05）。糖尿病组患者在入院时和入院14 d后统计了CSS评分，显示为糖尿病组平均值高于非糖尿病组，两组结果差异有统计学意义（P<0.05）。 结论 急性脑梗死合并2型糖尿病患者的血清Hcy水平和CSS评分要比非糖尿病患者高，糖尿病组的预后比非糖尿病组差，因此，高血清Hcy应该要引起重视，积极改善该指标能够让患者的病程发展延缓。

[关键词] 急性脑梗死；2型糖尿病；同型半胱氨酸；预后影响

[中图分类号] R743.33 [文献标识码] A [文章编号] 1672-4062（2018）01（b）-0019-02

Study on Effect of Homocysteine Level of Patients with Acute Cerebral Infraction and Type 2 Diabetes on the Prognosis

GAO Xiao-yan， GU Yan， ZHOU Ping-ping， CHEN Gang， XIA Cai-qiu

Department of Neurology， Cerebral vascular Hospital of Daqing Oilfield， Daqing， Heilongjiang Province， 163000 China

[Abstract] Objective To research and analyze the effect of homocysteine level of patients with acute cerebral infraction and type 2 diabetes on the prognosis thus providing reference for the clinic. Methods 84 cases of patients with acute cerebral infraction in our hospital from October 2013 to October 2014 were selected and divided into two groups， including 48 cases in the diabetes group and 36 cases in the non-diabetes group， and the 72 h dynamic blood glucose was compared between the two groups， and the CSS and Hcy level were compared before and after treatment. Results The average Hcy level in the diabetic group and in the non-diabetic group was respectively （27.97±13.83）μmo1/L and （19.79±8. 64）μmo1/L， and the difference in the Hcy level between the two groups was statistically significant（P<0.05）， and the CSS scores at admission and in 14 d after admission of patients were counted， which showed that the average value in the diabetic group was higher than that in the non-diabetic group， and the difference was statistically significant（P<0.05）. Conclusion The Hcy level and CSS score of patients with acute cerebral infraction and type 2 diabetes are higher than those in the non-diabetic group， and the prognosis in the diabetes group is worse than that in the non-diabetic group， therefore， we should attach importance to the high serum Hcy level， and the active improvement of the index can prolong the disease course of patients.

[Key words] Acute cerebral infraction； Type 2 diabetes； Hcy； Effect on prognosis

急性腦血管病是对人体危害较大的一类疾病，患者死亡率和残疾率很高，患者动脉粥样硬化会让患者出现脑血管疾病，导致高血糖动脉粥样硬化。根据目前的临床研究显示，高Hcy血症也是脑血管疾病高发的重要因素[1]。选取2013年10月—2014年10月该院收治的2型糖尿病急性脑梗死患者和非糖尿病急性脑梗死患者进行研究分析，对该指标和患者的预后情况联系性进行分析，现报道如下。

1 资料与方法

1.1 一般资料

选取了84例来该院接受治疗的急性脑梗死患者，患者接受诊断距离发病时间不足24 h，根据缺血性脑卒中治疗方式为患者进行规范治疗，分成糖尿病组48例和非糖尿病组36例。糖尿病组有29例男性和19例女性，年龄53～76岁，平均（65.76±9.79）岁。非糖尿病组有21例男性，15例女性，年龄55～77岁，平均（64.98±9.76）岁。……