二甲双胍对2型糖尿病伴缺血性脑卒中患者神经功能、血液黏度及认知功能的影响

目的观察二甲双胍对2型糖尿病伴缺血性脑卒中患者神经功能、血液黏度及认知功能的影响。方法选取本院200例2型糖尿病伴缺血性脑卒中患者,以数字表法随机分为两组各100例,常规组予以常规治疗,二甲双胍组在常规组基础上予以二甲双胍缓释片,比较两组治疗前后空腹血糖(FPG)、糖化血红蛋白(HbA1c)、超敏C反应蛋白(hs-CRP)、血脂、血液黏度、美国国立卫生研究院卒中量表(NIHSS)评分、蒙特利尔认知评估量表(MoCA)评分、改良Rankin量表(mRS)评分、Barthel指数。结果治疗后,二甲双胍组FPG、HbA1c、hs-CRP、TC、LDL-C、TG水平低于常规组,HDL-C水平高于常规组(P<0.05);二甲双胍组血细胞比容、血浆黏度、全血低切黏度、全血高切黏度及NIHSS评分、mRS评分低于常规组,MoCA评分、Barthel指数高于常规组(P<0.05)。结论二甲双胍可有效促进2型糖尿病伴缺血性脑卒中患者神经功能、认知功能恢复,提高其日常生活能力,可能与其较好协同降糖、调血脂作用、改善血液流变学及炎症反应有关。

The effect of metformin on recovery of neurological function,blood viscosity and cognitive dysfunction in patients with type 2 diabetes mellitus and ischemic stroke

Objective To observe the effect of metformin on recovery of neurological function,blood viscosity and cognitive dysfunction in patients with type 2 diabetes mellitus and ischemic stroke.Methods Two hundred patients with type 2 diabetes mellitus and ischemic stroke in our hospital were enrolled and divided into routine and metformin group by using the random number table method,100 in each group.The routine group was given routine treatment and the metformin group was treated with metformin sustained-release tablets on the basis of routine treatment.Fasting plasma glucose(FPG),glycated hemoglobin(HbA1c),high-sensitivity C-reactive protein(hs-CRP),blood lipids,blood viscosity,National Institutes of Health Stroke Scale(NIHSS)scores,Montreal Cognitive Assessment Scale(MoCA)scores,modified Rankin Scale(mRS)scores and Barthel index were compared between the 2 groups before and after treatment.Results After treatment,the metformin group had significantly lower levels of FPG,HbA1c,hs-CRP,TC,LDL-C and TG but significantly higher HDL-C level when compared to the routine group(P<0.05).Hematocrit,plasma viscosity,whole blood low shear viscosity,whole blood high shear viscosity,NIHSS scores and MRS scores of the metformin group were significantly lower than those of the routine group(P<0.05)while MoCA scores and Barthel index were significantly higher than the routine group(P<0.05).Conclusion Metformin can effectively promote the recovery of neurological and cognitive functions in patients with type 2 diabetes mellitus and ischemic stroke,and improve their activities of daily living.These may be related to its better synergistic effect on lowering blood glucose,regulating blood lipids and improving hemorheology and inflammatory response.