【摘要】 目的 研究2型糖尿?。╰ype 2 diabetes mellitus，T2DM）合并非酒精性脂肪性肝?。╪on-alcoholic fatty liver disease， NAFLD）患者血漿脂肪細胞特異性脂肪酸結合蛋白（adipocyte-specific fatty acid-binding protein，A-FABP）的水平及其相關因素。 方法 2009年10月—2010年10月選取T2DM合并NAFLD組（A組）60例，未合并NAFLD組56例（B組）為研究對象。測定體質量指數（body mass index，BMI），檢測血脂、糖化血紅蛋白（hemoglobin A1c，HbA1c）等生化指標。放射免疫法測定空腹胰島素（fasting insulin，FINS），空腹C肽水平（fasting C-peptide，FCP），計算胰島素抵抗指數（homeostasis model of assessment-insulin resistance，HOMA-IR）、胰島素敏感指數（insulin sensitivity index，ISI），測定A-FABP、C反應蛋白（C-reaction protein，CRP）及腫瘤壞死因子-α（tumor necrosis factor-α，TNF-α）?！〗Y果 與B組患者相比，A組患者其血漿A-FABP水平、BMI、腰圍、腰臀比、丙氨酸氨基轉移酶、門冬氨酸氨基轉移酶、CRP、TNF-α、FCP、FINS、總膽固醇、甘油三酯、Ln（HOMA-IR）升高，Ln（ISI）降低，差異有統(tǒng)計學意義（Plt;0.05）；兩組HbA1c差異無統(tǒng)計學意義（Pgt;0.05）。A-FABP水平變化與TNF-α、HOMA-IR、CRP呈正相關，與ISI呈負相關。 結論 T2DM伴NAFLD中，A-FABP升高與胰島素抵抗是并存的，且存在明顯相關關系，二者在疾病的發(fā)生發(fā)展中均可能具有重要的作用?！続bstract】 Objective To analyze the serum level of adipocyte-specific fatty acid-binding protein (A-FABP) in patients with type 2 diabetes mellitus (T2DM) complicated with non-alcoholic fatty liver disease (NAFLD), and its related factors. Methods From October 2009 to October 2010, 112 patients with T2DM were categorized into two groups: the group with NAFLD (group A) with 60 patients, and the group without NAFLD (group B) with 56 patients. Body mass index (BMI), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and hemoglobin A1c (HbA1c) were detected. Radioimmunoassay was carried out to measure fasting insulin (FINS) and fasting C-peptide (FCP), and homeostasis model of assessment-insulin resistance (HOMA-IR) and insulin sensitivity index (ISI) were calculated. At the same time, A-FABP, C-reaction protein (CRP) and tumor necrosis factor-α (TNF-α) were also detected. Results Compared with patients in group B, plasma levels of A-FABP, BMI, waistline, waist to hip ratio, ALT, AST, TG, TC, HDL-C, LDL-C, CRP, FCP, FINS, and HOMA-IR for patients in group A were all higher, while ISI was lower; and the differences in the above-mentioned parameters were statistically significant (Plt;0.05). The levels of HbA1c in the two groups were not significantly different (Pgt;0.05). The change of A-FABP level was positively correlated with TNF-α, HOMA-IR and CRP, while it wasnegatively correlated with ISI. Conclusions In patients with T2DM with NAFLD, there is an obvious correlation between the coexisting A-FABP rise and insulin resistance. Both of them played critical roles in the onset and developing of the disease.
腦卒中具有發(fā)病率高、死亡率高和致殘率高的特點，多數患者在腦卒中后均會出現一定的運動功能障礙，這極大地影響了患者的正常生活。而足下垂作為腦卒中后的常見后遺癥，嚴重影響了患者行走的步態(tài)，限制了患者的活動，降低了患者的生活質量。近年來，重復外周磁刺激越來越多地被應用到各種疾病的康復治療中，并因其具有無創(chuàng)、經濟、有效等特點被很多患者接受。該文就重復外周磁刺激應用于腦卒中后足下垂的研究進展進行綜述。