急性动脉粥样硬化型脑梗死患者血清 CXCL16水平与2型糖尿病的相关性研究

摘要

目的：探讨血清 CXCL16水平与2型糖尿病、急性脑梗死的关系。方法选取2013年1月至2013年12月在石河子大学医学院第一附属医院神经内科住院的30例脑梗死患者（CI 组）、30例2型糖尿病患者（DM 组）、30例2型糖尿病合并脑梗死患者（DM + CI 组）及30例同期体检健康者（对照组）。比较各组受检者的总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL）、Hcy、糖化血红蛋白（ HbA1c）、CXC 趋化因子配体16（CXCL16）水平，采用 Pearson 相关分析 CXCL16的相关因素；采用二分类 Logistic回归分析2型糖尿病合并脑梗死的影响因素。结果①4组受检者 TG、TC、LDL、CXCL16、HbA1c、Hcy 水平比较，除 TC 外，差异均有统计学意义（P ﹤0.05）；CI+DM 组、DM 组、CI 组 CXCL16的水平均高于对照组，其中 CI+DM 组最高[0.747（0.839），P ﹤0.05]；②血糖控制未达标（HbA1c ≥6.5%）者血清 CXCL16水平高于血糖控制达标（ HbA1c ﹤6.5%）者[（0.839±0.708）ng·mL-1与（0.526±0.865） ng·mL-1，t =-2.005，P =0.047]；③ Pearson 相关分析显示，血清 CXCL16水平与 NIHSS 评分、HbA1c 水平均成正相关（r 分别为0.318,0.376，P 值分别为0.013,0.001）。结论 CXCL16在急性脑梗死及糖尿病患者血清中表达明显增高，与神经功能缺损程度及血糖水平有明显的正相关关系，可以作为评估急性动脉粥样硬化型脑梗死及合并2型糖尿病患者预后的一个指标。%Objective To explore the level and clinical significance of CXCL16 in type 2 diabetes mellitus patients combined with cerebral infarction Method The patients who were admitted to the First Affiliated Hospital of Shihezi University from January 2013 to December 2013,were selected as study subjects,30 patients with cerebral infarction were included in CI group,30 patients with type 2 diabetes mellitus were included in DM group,and 30 patients with type 2 diabetes mellitus and cerebral infarction were included in DM + CI group,and 30 healthy people were included in control group. The levels of TC,TG,LDL Hcy,HbA1c,CXCL16 were compared among groups. The relevant factors for CXCL16 levels were analyzed by pearson correlation analysis. The influencing factors for type 2 diabetes complicated with cerebral infarction were analyzed by a binary Logistic regression model. Results ① There were significant differences in serum levels of TG,LDL,CXCL16、HbA1c,Hcy among 4 groups(P ﹤ 0.05); ②The serum CXCL16 levels in those who did not maintain adequate blood glucose(HbA1c ≥ 6.5%)were significantly higher than those who maintained adequate blood glucose(HbA1c ﹤ 6.5%)[( 0.839±0.708)ng·mL-1 vs. (0.526±0.865)ng·mL-1,t =-2.005,P =0.047]; ③ According to result of Pearson correlation analysis,serum levels of HbA1c,NIHSS score were positively correlated with CXCL16 level(rvalue was 0.318,0.376;P=0.013,0.001)Conclusion CXCL16 in serum of patients with acute cerebral infarction and diabetes expression increased significantly, and had a significantly positive correlation with degree of nervous function defect and blood glucose level can be evaluated as an indicator of acute atherosclerosis cerebral infarction and type 2 diabetic patients prognosis.