| Objective: retrospective analysis of clinical data of cerebral infarction complicated with type 2 diabetes mellitus and cerebral infarction complicated without type 2 diabetes mellitus,compared two groups of records in the biochemical indexes: fasting blood glucose(FBG),glycosylated hemoglobin(Hb A1c),three glycerol(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDLC).Low density lipoprotein cholesterol(LDL-C),low density lipoprotein cholesterol(VLDL-C),urea nitrogen(BUN),creatinine(CR),uric acid(UA),high sensitive C reactive protein(hs-CRP),National Institutes of Health Stroke Scale(NIHSS)score changes;Medical records in the two groups of platelet parameters(platelet count,mean platelet volume,platelet distribution width)change characteristic;the cerebral infarction patients with type 2 diabetes mellitus were divided into 3 subgroups,according to NIHSS score,cerebral infarction type and cerebral infarction position,compare the change among groups of platelet parameters;cerebral infarction were given aspirin antiplatelet therapy for 14 days in 621 patients with type 2 diabetes mellitus group,to observe the changes of platelet parameters of platelet before and after treatment.The clinical features associated with cerebral infarction platelet parameters to define diabetes;pay attention to the clinical practice in the treatment of intensive antiplatelet therapy.Reduce the disease progression of acute ischemic stroke,reduce disability and death occurred.Methods: medical records from January 2013 to December 2015 group in the Department of Neurology Second Hospital Affiliated to Tianjin Medical University inpatients,1499 patients with acute cerebral infarction patients had complete data screening,including cerebral infarction patients with type 2 diabetes mellitus(DM group)987 cases,cerebral infarction without type 2 diabetes patients(non DM group)512 cases.The parameters of blood cell analyzer to test platelet count(PC),mean platelet volume(MPV),platelet distribution width(PDW);the National Institutes of Health Stroke Scale(NIHSS)evaluation on nerve function defect by biochemical analyzer test;blood biochemical indicators,fasting blood glucose(FBG),glycosylated hemoglobin(Hb A1c),triglyceride(TG)three(TC),total cholesterol,high density lipoprotein cholesterol(HDLC),low density lipoprotein cholesterol(LDL-C),low density lipoprotein cholesterol(VLDL-C),urea nitrogen(BUN),creatinine(CR),Uric acid(UA),high-sensitivity C reactive protein(hs-CRP).The cerebral infarction with diabetes were divided into 3 subgroups according to NIHSS score,cerebral infarction type and cerebral infarction position,to investigate the changes of platelet parameters in each sub group of cerebral infarction with diabetes group.Results: 1 Acute cerebral infarction patients with diabetes group,total cholesterol,low density lipoprotein cholesterol,high-sensitivity C-reactive protein,glycosylated hemoglobin,fasting blood glucose were higher than that of cerebral infarction without diabetes group;mean platelet volume was higher than that in non diabetic cerebral infarction group,with statistical significance.2 Comparison of changes of platelet parameters before and after cerebral infarction with diabetes group antiplatelet given aspirin,100mg/d,platelet parameters in comparison hospitalized for fourteenth days and first days,the difference was not statistically significance.3 changes of cerebral infarction with diabetes subgroups are divided into: 1)according to the severity of cerebral infarction divided according to the NIHSS score of cerebral infarction with diabetes were divided into severe group(nihss>4)and severity(mild group nihss<=4),MPV of the former than the latter,with statistical significance.2)according to the lesion location,cerebral infarction combined with diabetes was divided into anterior circulation cerebral infarction group and posterior circulation cerebral infarction group,no significant differences between the two groups of platelet parameters.3)according to the size of cerebral infarction,cerebral infarction 1patients were divided into lacunar infarction group and non lacunar infarction group,non lacunar infarction group MPV higher than lacunar infarction group,with statistical significance,except other platelet parameters.Conclusion: 1.Compared with diabetic patients,the changes of platelet parameters were more obvious in patients with cerebral infarction combined with diabetes mellitus.The main manifestation was the increase of MPV.2.Of the patients with cerebral infarction compared with patients without diabetes,inflammatory marker levels of hs-CRP,TC VLDL-C and Hb A1 c level of blood lipid,and increased the level of FBG has positive effect on atherosclerosis,may exacerbate the changes of platelet parameters,promote thrombosis.3.In patients of cerebral infarction complicated with diabetes,the severity of the disease,the larger size of the infarction patients,changed in platelet parameters,mainly in the rise of MPV.4.the changes of platelet parameters in patients with cerebral infarction complicated with diabetes mellitus after antiplatelet therapy are not statistical significance.There may be a decrease in the reactivity of antiplatelet drugs,and should more sensitive indexes should be further evaluated in future. |
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