缺血预适应对脑梗死患者疗效及血清凋亡相关因子水平的影响
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摘要
目的观察缺血预适应对脑梗死患者疗效及其对血清凋亡相关因子水平的影响。方法选取2015年1月—2018年1月襄阳市中心医院/湖北省文理学院附属医院神经内科诊治的脑梗死患者130例作为研究对象,根据患者梗死前是否出现短暂性脑缺血发作分为缺血预适应(IPC)组和非缺血预适应(NIPC)组,检测2组患者血清中可溶性凋亡相关因子(sFas)及其配体(sFasL)、可溶性肿瘤坏死因子相关性凋亡诱导配体(sTRAIL)、骨保护素(OPG)和三酰甘油(TG)、低密度脂蛋白固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FPG)水平;检测血浆黏度及红细胞压积;测定神经功能缺损评分(NIHSS评分)、BI评分。结果与NIPC组比较,IPC治疗后sFas、sTRAIL、OPG、FPG、TG、LDL-C、血浆黏度、红细胞压积和NIHSS评分显著降低(t=20. 568、11.068、18. 484、7. 794、6. 580、4. 541、10.117、6. 556、3. 943,P均<0. 01),sFasL、HDL-C和BI评分升高(t=9.441、7. 068、3. 708,P均<0.01)。结论缺血预适应可以有效降低脑梗死患者血清凋亡相关因子水平,并降低缺血对脑神经的损伤。
Objective To observe the effect of ischemic preconditioning on cerebral infarction patients and its effect on serum apoptosis-related factors. Methods One hundred and thirty patients with cerebral infarction diagnosed and treated by Neurology Department of Xiangyang Central Hospital/Affiliated Hospital of Hubei Academy of Arts and Sciences from January 2015 to January 2018 were selected as subjects. According to whether the patients had transient ischemic attack before infarction,they were divided into ischemic preconditioning(IPC) group and non-ischemic preconditioning(NIPC) group. Soluble apoptotic related factors(sFas) in serum of the two groups were determined by ELISA. Its ligands(sFasL), soluble tumor necrosis factor-related apoptotic inducing ligand(sTRAIL), osteoprotegerin(OPG), triglyceride(TG), low density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol(HDL-C), fasting blood sugar(FPG), plasma viscosity and hematocrit were measured; neurological deficit score(NIHSS score) and BI score were used. Results Compared with the NIPC group, plasma viscosity, hematocrit, and NIHSS scores of sFas, sTRAIL, OPG,FPG, TG, and LDL-C were significantly lower after IPC treatment( t=20. 568,t = 11. 068,t = 18. 484,t =7. 794,t= 6. 580,t =4. 541,t= 10. 117,t=6.556, t =3.943, P <0.01), sFasL, HDL-C and BI scores increased( t =9.441, t =7.068, t =3.708. P<0.01).Conclusion Ischemic preconditioning can effectively reduce the level of apoptotic related factors in serum of patients with cerebral infarction, and reduce the damage of cerebral nerve caused by ischemia.
Objective To observe the effect of ischemic preconditioning on cerebral infarction patients and its effect on serum apoptosis-related factors. Methods One hundred and thirty patients with cerebral infarction diagnosed and treated by Neurology Department of Xiangyang Central Hospital/Affiliated Hospital of Hubei Academy of Arts and Sciences from January 2015 to January 2018 were selected as subjects. According to whether the patients had transient ischemic attack before infarction,they were divided into ischemic preconditioning(IPC) group and non-ischemic preconditioning(NIPC) group. Soluble apoptotic related factors(sFas) in serum of the two groups were determined by ELISA. Its ligands(sFasL), soluble tumor necrosis factor-related apoptotic inducing ligand(sTRAIL), osteoprotegerin(OPG), triglyceride(TG), low density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol(HDL-C), fasting blood sugar(FPG), plasma viscosity and hematocrit were measured; neurological deficit score(NIHSS score) and BI score were used. Results Compared with the NIPC group, plasma viscosity, hematocrit, and NIHSS scores of sFas, sTRAIL, OPG,FPG, TG, and LDL-C were significantly lower after IPC treatment( t=20. 568,t = 11. 068,t = 18. 484,t =7. 794,t= 6. 580,t =4. 541,t= 10. 117,t=6.556, t =3.943, P <0.01), sFasL, HDL-C and BI scores increased( t =9.441, t =7.068, t =3.708. P<0.01).Conclusion Ischemic preconditioning can effectively reduce the level of apoptotic related factors in serum of patients with cerebral infarction, and reduce the damage of cerebral nerve caused by ischemia.
引文
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[12]王瑾,柳江海,卢建国.血栓通对脑梗死患者纤溶凝血系统及血液黏度的影响[J].实用临床医药杂志,2017,21(13):163-165. D0I:10.7619/jcmp.201713054.
[13]戢运建,况娥.脑卒中后抑郁患者血清TSH含量与神经递质、神经营养状态及神经细胞凋亡的关系[J].海南医学院学报,2017,23(9):1276-1278, 1282. DOI:10. 13210/j. cnki. jhmu.20170607.019.
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[15]徐洪波,胡一迪,程水兵,等.自拟益气利水方治疗颅脑损伤后脑水肿的疗效观察[J].中国中医急症,2017,26(12):2240-2242. DOI:10.3969/j. issn. 1004-745X. 2017.12.054.
[16]郗红艳,司志华,李家承,等.ABCD2评分联合血浆纤维蛋白原水平早期预测短暂性脑缺血发作患者发生脑梗死的风险[J].疑难病杂志,2018,17(11):1200-1204. D01:10. 3969/j. issn.1671-6450.2018.11.004.
[17]许云鹤,刘永刚,赵小妹,等.丁苯酞注射液治疗急性脑梗死的疗效及对血清sTRAIL OPG TNF-a的影响[J].中国实用神经疾病杂志,2016, 19(13):34. DOI:10. 3969/j. issn. 1673-5110.2016.13.002.
[18]董亚茹,薛秀云,韩彩萍,等.阿替普酶对急性脑梗死疗效及其对神经功能损伤程度、实验室指标影响[J].疑难病杂志,2018,17(8):771-775. DOI:10.3969/j. issn. 1671-6450.2018.08.004.
[19]鲁慧,王彬成,崔宁宁,等.缺血预适应预防和治疗老年脑梗塞的疗效观察[J].现代生物医学进展,2017,17(15):2941-2943.D01:10. 13241/j. cnki. pmb. 2017. 15.037.
[2] Minutoli L, Puzzolo D, Rinaldi M, et al. ROS-Mediated NLRP3 Inflammasome Activation in Brain, Heart, Kidney, and Testis Ischemia/Reperfusion Injury[J]. Oxidative Medicine&Cellular Longevity, 2016, 2016:2183026. DOI:10. 1155/2016/2183026.
[3] Yu F, Liang H, Xin S. Renal ischemia reperfusion causes brain hippocampus oxidative damage ang inhibition effect[J]. African Journal of Traditional Complementary&Alternative Medicines,2016, 13(5):61-66. DOI:10.21010/ajtcam. v13i5.9.
[4] Wu W, Guan Y, Xu K, et al. Plasma Homocysteine Levels Predict the Risk of Acute Cerebral Infarction in Patients with Carotid Artery Lesions[J]. Molecular Neurobiology, 2016, 53(4):2510-2517.DOI:10.1007/s12035-015-9226-y.
[5]王海波,曹文慧,安宁,等.微创介入治疗对急性脑梗死患者血清相关细胞因子及生活质量的影响[J].现代生物医学进展,2016,16(29):5730-5732. DOI:10.13241/j. cnki. pmb. 2016.29.035.
[6]郭海燕,童晨光,张晓晖,等.急性脑梗死中医证型与NIHSS评分关系的研究[J].中西医结合心脑血管病杂志,2013, 11(2):167. DOI:10.3969/j. issn. 1672-1349.2013.02.023.
[7]李佩云,李春芳,孙力.高压氧疗法对颅脑损伤患者BI指数、GCS、SAS、SDS的影响[J].海南医学院学报,2017, 23(16):2289-2291. DOI:10.13210/j. cnki. jhmu. 20170816.003.
[8]李佳佳,马征.急性脑梗死溶栓疗效与TOAST分型的关系研究[J].实用临床医药杂志,2017,21(23):205-206.DOI:10.7619/j. issn. 7619/jcmp. 201723083.
[9]彭智远,刘旺华,曹雯.脑缺血再灌注损伤细胞凋亡机制的研究进展[J].中华中医药学刊,2017,35(8):1957-1961. DOI:1673-7717.2017.08.008.
[10] Ge Y, Cai YM, Bonneau L, et al. Inhibition of cathepsin B by caspase-3 inhibitors blocks programmed cell death inArabidopsis[J].Cell Death&Differentiation, 2016, 23(9):1493-1501. DOI:10.1038/cdd.2016.34.
[11]徐丹,陶陶,张继荣,等.HIF-1α对脑缺血再灌注损伤细胞凋亡及凋亡相关基因的研究进展[J].中国神经免疫学和神经病学杂志,2017, 24(3):219-222. DOI:10. 3969/j. issn. 1006-2963.2017.03.016.
[12]王瑾,柳江海,卢建国.血栓通对脑梗死患者纤溶凝血系统及血液黏度的影响[J].实用临床医药杂志,2017,21(13):163-165. D0I:10.7619/jcmp.201713054.
[13]戢运建,况娥.脑卒中后抑郁患者血清TSH含量与神经递质、神经营养状态及神经细胞凋亡的关系[J].海南医学院学报,2017,23(9):1276-1278, 1282. DOI:10. 13210/j. cnki. jhmu.20170607.019.
[14]王校伟,冯春国.脑出血患者血清细胞因子的动态变化及其与周围脑组织水肿的相关性[J].实用临床医药杂志,2015, 19(5):25-27. DOI:10.7619/jcmp.201505008.
[15]徐洪波,胡一迪,程水兵,等.自拟益气利水方治疗颅脑损伤后脑水肿的疗效观察[J].中国中医急症,2017,26(12):2240-2242. DOI:10.3969/j. issn. 1004-745X. 2017.12.054.
[16]郗红艳,司志华,李家承,等.ABCD2评分联合血浆纤维蛋白原水平早期预测短暂性脑缺血发作患者发生脑梗死的风险[J].疑难病杂志,2018,17(11):1200-1204. D01:10. 3969/j. issn.1671-6450.2018.11.004.
[17]许云鹤,刘永刚,赵小妹,等.丁苯酞注射液治疗急性脑梗死的疗效及对血清sTRAIL OPG TNF-a的影响[J].中国实用神经疾病杂志,2016, 19(13):34. DOI:10. 3969/j. issn. 1673-5110.2016.13.002.
[18]董亚茹,薛秀云,韩彩萍,等.阿替普酶对急性脑梗死疗效及其对神经功能损伤程度、实验室指标影响[J].疑难病杂志,2018,17(8):771-775. DOI:10.3969/j. issn. 1671-6450.2018.08.004.
[19]鲁慧,王彬成,崔宁宁,等.缺血预适应预防和治疗老年脑梗塞的疗效观察[J].现代生物医学进展,2017,17(15):2941-2943.D01:10. 13241/j. cnki. pmb. 2017. 15.037.