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目的：探讨血浆可溶性血栓调节蛋白(soluble thrombomodulin，sTM) 与2 型糖尿病脑梗死(type2 diabetes mellitus cerebral infarction，DMCI)的关系及其临床意义。方法：选择2011 年12 月至2012 年8 月我科收治的急性脑梗死(acute cerebral infarction， ACI)患者60 例，其中DMCI患者30 例，非2 型糖尿病合并脑梗死(non-diabetes mellitus cerebral infarction，NDMCI)患者30 例，以及同期健康体检者30 例。采用酶联免疫吸附法(ELISA)检测其血浆sTM水平，并按美国国立卫生研究所脑卒中评分(NIHSS)进行临床神经功能缺损评估。结果：(1)与正常对照组相比，DMCI组及NDMCI组患者血浆sTM 水平均明显升高，差异有统计学意义 (P<0.01)；(2)DMCI 组患者血浆sTM 水平和NIHSS评分均较NDMCI 组显著升高，差异有统计学意义(P<0.01)；(3)DMCI 组和 NDMCI组患者血浆sTM水平与NIHSS 评分呈显著正相关，(r=0.785，P<0.001)。结论：2 型糖尿病脑梗死患者血浆sTM水平较正常人群显著升高，且与其神经功能缺损的严重程度呈显著正相关，检测血浆sTM 水平可有助于评估2 型糖尿病合并脑梗死的分期、严重程度及其转归。

英文摘要:

Objective:To explor changes and clinical significance of plasma soluble thrombomodulin (sTM) level in diabetes mellitus cerebral infarction (DMCI).Methods:fromDecember 2011 to August 2012, 60 Acute Cerebral Infarction patients treated in our hospital were selected and their data were collected, 30 cases with typy2 diabetes mellitus (DM) and 30 Non- typy2 diabetes mellitus cerebral infarction (NDM) cases, and 30 healthy subjects over the same period were as control, the plasma sTM level were detected by enzyme linked immunosorbent assay（ELISA）, and the seventies of neurological impairment were assessed by the National Institute of Health Stroke Scale score (NIHSS).Results:(1)As compared to healthy subjects, the plasma level of sTM both in DMCI group and NDMCI group were higher (P<0.01).(2)The level of DMCI plasma sTM and NIHSS scores compared with NDMCI group increased significantly, the difference was statistically significant (P<0.01). (3)The plasma level of sTMand NIHSS score is significantly positive correlation in DMCI group and NDMCI group (r=0.786, P<0.001).Conclusion:The plasma level of sTM in DMCI group is inceased significantly than normal group, and it is significant positive correlation with severity of neurological impairment. It suggested that the plasma level of sTMcan be helpful in assessing the stage,severity and outcome of type 2 diabetes mellitus cerebral infarction.

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