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目的探索急性期脑梗死(ACI)合并2型糖尿病的氧化应激程度。方法入选急性脑梗死患者97例,其中合并2型糖尿病50例(ACI糖尿病组),无糖尿病者47例(ACI无糖尿病组)。观察入选ACI患者发病48 h的神经功能缺失程度评分(NIHSS)、改良Rankin评分(mRS)评分;检测空腹血糖、糖化血红蛋白、血脂、hs-CRP、炎性因子(IL-1、IL-6、TNF-α)和血清8-羟基脱氧鸟苷酸(8-OHdG)、丙二醛(MDA)和超氧化物歧化酶(SOD)水平。结果发病48 h ACI糖尿病组血清8-OHdG(0.73±0.38)ng·m L~(-1)和MDA(4.32±1.93)nmol·m L~(-1),较ACI无糖尿病组血清8-OHdG(0.51±0.31)ng·m L~(-1)和MDA(3.21±1.16)nmol·m L~(-1)均明显升高,差异有统计学意义(分别P=0.002和P=0.001)。SOD在两组中差异无统计学意义[(133.44±18.16)U·m L~(-1) vs(134.89±19.17)U·m L~(-1)]。IL-1、IL-6、TNF-α在ACI糖尿病组患者血清中均明显升高。结论 ACI糖尿病患者较无糖尿病患者存在更明显的氧化应激反应,针对这类患者进行清除自由基及减少氧化应激损伤可能对临床治疗有一定的指导意义。
Objective To explore the degree of oxidative stress in acute cerebral infarction (ACI) with type 2 diabetes. Methods A total of 97 patients with acute cerebral infarction were enrolled. Among them, 50 patients with type 2 diabetes mellitus (ACI diabetic group) and 47 patients without diabetes mellitus (ACI non - diabetic group). The scores of neurological deficit score (NIHSS) and modified Rankin score (mRS) at 48 h after onset of ACI were observed. The levels of fasting blood glucose, glycosylated hemoglobin, serum lipids, hs-CRP and inflammatory cytokines (IL- TNF-α and 8-OHdG, MDA and SOD were measured. Results Serum levels of 8-OHdG (0.73 ± 0.38) ng · m L -1 and MDA (4.32 ± 1.93) nmol · m L -1 in ACI diabetic rats at 48 h after onset were significantly higher than those in ACI- The levels of OHdG (0.51 ± 0.31) ng · m L -1 and MDA (3.21 ± 1.16) nmol · m L -1 were significantly higher than those of the control group (P = 0.002 and P = 0.001, respectively ). There was no significant difference in SOD between the two groups ([(133.44 ± 18.16) U · m L -1 vs (134.89 ± 19.17) U · m L -1]. IL-1, IL-6 and TNF-α in serum of patients with ACI diabetes mellitus were significantly increased. Conclusion There is more obvious oxidative stress response in ACI diabetic patients than in non-diabetic patients. It may be helpful for clinical treatment to scavenge free radicals and reduce oxidative stress injury in these patients.