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目的:探讨2型糖尿病合并脑梗死的中老年患者血清胱抑素-C(cystatin C,Cys-C)、同型半胱氨酸(Hcy)、基质金属蛋白酶-9(MMP-9)的变化及临床意义。方法:选取来我院就诊的中老年2型糖尿病(DM)患者126例,其中合并脑梗死的患者30例,单纯糖尿病患者96例,选择同期来我院行健康体检的健康对照者36例。测定所有受试者的空腹血糖(FBG)、甘油三酯(TG)、胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、糖化血红蛋白(Hb A1C)、血清Cys-C、Hcy、MMP-9的水平及颈动脉内膜中层厚度(CIMT)。结果:2型糖尿病合并脑梗死、单纯2型糖尿病的受试者的FBG、TG、TC、LDL、HDL、Hb A1C、血清Cys-C、Hcy、MMP-9及CIMT与健康对照组差异有显著差异,且2型糖尿病合并脑梗死的各指标与单纯2型糖尿病差异亦有显著差异。血清Cys-C水平与CIMT呈正相关。血清Cys-C可能是2型糖尿病合并脑梗死发病的独立预测因子。结论:联合血清CYS-C、Hcy、MMP-9水平的测定对预测中老年人2型糖尿病合并脑梗死可能更优。
Objective: To investigate the changes of serum cystatin C (Cys-C), homocysteine (Hcy) and matrix metalloproteinase-9 (MMP-9) in middle-aged and elderly patients with type 2 diabetes mellitus complicated with cerebral infarction Clinical significance. Methods: A total of 126 elderly patients with type 2 diabetes mellitus (DM) were enrolled in our hospital. Of them, 30 were complicated with cerebral infarction, 96 were simple diabetic patients, and 36 were healthy controls in our hospital during the same period. Fasting blood glucose (FBG), triglyceride (TG), cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL), glycosylated hemoglobin (Hb A1C), serum Cys- C, Hcy, MMP-9 levels and carotid intima-media thickness (CIMT). Results: The FBG, TG, TC, LDL, HDL, Hb A1C, serum Cys-C, Hcy, MMP-9 and CIMT in type 2 diabetic patients with cerebral infarction and type 2 diabetes were significantly different from those in healthy controls Differences, and type 2 diabetes mellitus with cerebral infarction indicators and simple type 2 diabetes also had significant differences. Serum Cys-C level was positively correlated with CIMT. Serum Cys-C may be an independent predictor of type 2 diabetes with cerebral infarction. Conclusion: The determination of serum CYS-C, Hcy and MMP-9 levels may be more effective in predicting type 2 diabetes complicated with cerebral infarction in middle-aged and elderly patients.