HICH患者LP(a)、GSN、HCY、vWF、sCD40L水平的变化及其意义
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摘要
目的分析高血压脑出血(HICH)患者血浆脂蛋白(a)[LP(a)]、凝溶胶蛋白(GSN)、同型半胱氨酸(HCY)、血管性血友病因子(vWF)、可溶性CD40L(sCD40L)水平的变化及其意义。方法选取我院神经外科(2015年4月-2018年3月)收治的85例HICH患者作为HICH组,根据美国国立健康研究所制定的急性脑卒中评定表(NIHSS)评分分为轻度组(22例),中度组(38例)和重度组(25例),根据GOS评分将出院患者分为预后良好组(52例)和预后不良组(33例)。选取同期100例单纯高血压患者作为单纯高血压组,选取同期100例健康体检作为健康组。分析各组患者LP(a)、GSN、HCY、vWF、sCD40L水平的变化及其意义。结果 HICH组和单纯高血压组患者LP (a)、HCY、vWF、sCD40L水平高于健康组,GSN水平低于健康组,且HICH组患者LP(a)、GSN、HCY、vWF、sCD40L水平与单纯高血压组比较,差异有统计学意义(P<0.05)。HICH组患者LP(a)、HCY、vWF、sCD40L水平随着神经损害程度增加而升高,GSN水平随着神经损害程度增加而下降,预后良好组LP(a)、HCY、vWF、sCD40L水平低于预后不良组,GSN水平高于预后不良组,差异有统计学意义(P<0.05)。结论 HICH患者LP(a)、HCY、vWF、sCD40L水平升高,GSN水平降低,相关因子的水平与神经损害程度和预后具有一定的相关性。
Objective To analyze the changes and significance of plasma lipoprotein(LPPA),GSNN,HCY,von Willebrand factor(vWFN) and soluble CD40 L(sCD40 L) in patients with hypertensive intracerebral hemorrhage(HICH). Methods Eighty-five patients with HICH were selected as HICH group from April 2015 to March 2018. According to the acute stroke assessment scale developed by the National Institutes of Health,the patients were divided into mild group(22 cases),moderate group(38 cases) and severe group(25 cases). According to GOS score,discharged patients were divided into good prognosis group(52 cases) and poor prognosis group(33 cases). One hundred patients with simple hypertension were selected as simple hypertension group and 100 healthy physical examination were selected as healthy group at the same period. The changes and significance of LP(a),GSN,HCY,vWF,sCD40 L levels were analyzed in each group. Results The levels of LP(a),HCY,vWF and sCD40 L in the HICH group and the simple hypertension group were higher than those in the healthy group,and the GSN level was lower than that in the healthy group. The levels of LP(a),GSN,HCY,and hypertension in the HICH group was statistically significant compared with those in the simple hypertension group. In HICH group,the levels of LP(a),HCY,VWF,sCD40 L increased with the degree of nerve damage,and the level of GSN decreased with the increase of the degree of nerve damage. The levels of LP(a),HCY,vWF and sCD40 L in the group with good prognosis were lower than those in the group with poor prognosis,and the levels of GSN were higher than those in the group with poor prognosis,with statistically significant differences(P<0.05). Conclusion In HICH patients,the levels of LP(a),HCY,vWF and sCD40 L were increased,while the levels of GSN were decreased. The levels of related factors were correlated with the degree of nerve damage and prognosis to some extent.
Objective To analyze the changes and significance of plasma lipoprotein(LPPA),GSNN,HCY,von Willebrand factor(vWFN) and soluble CD40 L(sCD40 L) in patients with hypertensive intracerebral hemorrhage(HICH). Methods Eighty-five patients with HICH were selected as HICH group from April 2015 to March 2018. According to the acute stroke assessment scale developed by the National Institutes of Health,the patients were divided into mild group(22 cases),moderate group(38 cases) and severe group(25 cases). According to GOS score,discharged patients were divided into good prognosis group(52 cases) and poor prognosis group(33 cases). One hundred patients with simple hypertension were selected as simple hypertension group and 100 healthy physical examination were selected as healthy group at the same period. The changes and significance of LP(a),GSN,HCY,vWF,sCD40 L levels were analyzed in each group. Results The levels of LP(a),HCY,vWF and sCD40 L in the HICH group and the simple hypertension group were higher than those in the healthy group,and the GSN level was lower than that in the healthy group. The levels of LP(a),GSN,HCY,and hypertension in the HICH group was statistically significant compared with those in the simple hypertension group. In HICH group,the levels of LP(a),HCY,VWF,sCD40 L increased with the degree of nerve damage,and the level of GSN decreased with the increase of the degree of nerve damage. The levels of LP(a),HCY,vWF and sCD40 L in the group with good prognosis were lower than those in the group with poor prognosis,and the levels of GSN were higher than those in the group with poor prognosis,with statistically significant differences(P<0.05). Conclusion In HICH patients,the levels of LP(a),HCY,vWF and sCD40 L were increased,while the levels of GSN were decreased. The levels of related factors were correlated with the degree of nerve damage and prognosis to some extent.
引文
[1]董娜,张雪青,穆恩.脑出血患者血清基质金属蛋自酶-9、细胞纤维连接蛋自变化及其相关性研究[J].中国老年学杂志,2016,7(36):3178-3180.
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[10]钟建斌,李协,钟思敏,等.破血逐瘀法联合依达拉奉对急性高血压脑出血患者血肿周围水肿及神经功能的影响[J].中国中西医结合急救杂志,2018,25(2):133-137.
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[13]孟亚楠,高萍,崔保玲,等.高血压脑出血患者血清血管性血友病因子和CD40水平变化及其相关性研究[J].贵州医药,2017,41(1):26-27.
[14]Riveralara L,Murthy SB,Nekoovaghttak S,et al.Influence of Bleeding Pattern on Ischemic Lesions After Spontaneous Hypertensive Intracerebral Hemorrhage with Intraventricular Hemorrhage.[J].Neurocrit Care,2018,12(Suppl 1):1-9.
[15]王京娥,陈燕,高山,等.IGF-1、HMGB-1、GSN和MIF水平在高血压脑出血中的意义[J].河北医药,2016,38(18):2733-2736.
[2]李奉辉,徐依成,陈新平,等.高血压脑出血血肿周围水肿与动态血压的相关性研究[J].中华老年心血管病杂志,2016,18(6):571-573.
[3]王育胜,柯以铨,洪映标,等.30~40ml高血压脑出血锁孔血肿清除术与内科保守疗法的疗效比较[J].中华神经医学杂志,2016,15(6):629-632.
[4]江光荣,周炜,罗立,等.血清同型半胱氨酸与C反应蛋白在急性脑血管病治疗效果评价中的临床价值[J].实验与检验医学,2017,35(5):771-773.
[5]甘正凯,蒋其俊,邓昭健,等.高血压脑出血患者围手术期血清神经递质、应激激素水平变化及意义[J].山东医药,2016,56(34):63-64.
[6]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华心血管病杂志,2011,39(7):579-616.
[7]中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-380.
[8]孙奉辉,徐依成,陈新平,等.高血压脑出血血肿周围水肿与动态血压的相关性研究[J].中华老年心脑血管病杂志,2016,18(6):571-573.
[9]马剑波,马冲,曹垒,等.血脂水平紊乱在青年高血压脑出血患者中的风险性研究[J].东南大学学报(医学版),2016,35(3):402-405.
[10]钟建斌,李协,钟思敏,等.破血逐瘀法联合依达拉奉对急性高血压脑出血患者血肿周围水肿及神经功能的影响[J].中国中西医结合急救杂志,2018,25(2):133-137.
[11]文志刚,耿灵军.神经节苷脂对高血压脑出血术后患者神经功能的影响[J].中国生化药物杂志,2016,36(9):132-134.
[12]Hessington A,Tsitsopoulos PP,Fahlstr?m A,et al.Favorable clinical outcome following surgical evacuation of deep-seated and lobar supratentorial intracerebral hemorrhage:a retrospective singlecenter analysis of 123 cases[J].Medicine,2018,97(22):1-11.
[13]孟亚楠,高萍,崔保玲,等.高血压脑出血患者血清血管性血友病因子和CD40水平变化及其相关性研究[J].贵州医药,2017,41(1):26-27.
[14]Riveralara L,Murthy SB,Nekoovaghttak S,et al.Influence of Bleeding Pattern on Ischemic Lesions After Spontaneous Hypertensive Intracerebral Hemorrhage with Intraventricular Hemorrhage.[J].Neurocrit Care,2018,12(Suppl 1):1-9.
[15]王京娥,陈燕,高山,等.IGF-1、HMGB-1、GSN和MIF水平在高血压脑出血中的意义[J].河北医药,2016,38(18):2733-2736.
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