| 急性部分前循环供血区脑梗死患者血清S100β蛋白、8-OHDG,Lp-PLA2水平与rt-PA静脉溶栓再通及卒中后认知功能障碍的关系 |
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| 引用本文： | 张弛,李浩,张淑霞,于海滨,王亚姣,冯社军.急性部分前循环供血区脑梗死患者血清S100β蛋白、8-OHDG,Lp-PLA2水平与rt-PA静脉溶栓再通及卒中后认知功能障碍的关系[J].卒中与神经疾病,2023,30(1):19-25. |
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| 作者姓名： | 张弛 李浩 张淑霞 于海滨 王亚姣 冯社军 |
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| 作者单位： | 063000 唐山弘慈医院有限公司神经内科(张弛 张淑霞 于海滨 王亚姣),重症医学科(李浩); 邯郸市中心医院神经内科(冯社军) |
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| 摘 要： | 目的 观察急性部分前循环供血区脑梗死(Partial anterior circulation infarction, PACI)患者血清S100β蛋白、8-羟基脱氧鸟苷酸(8-Hydroxydeoxyguanylate, 8-OHDG)、脂蛋白相关磷脂酶A2(Lipoprotein associated phospholipase A2,Lp-PLA2)水平变化，分析各指标水平与重组组织型纤溶酶原激活剂(Recombinant tissue plasminogen activator, rt-PA)静脉溶栓效果及12个月内发生卒中后认知功能障碍(Post-stroke cognitive impairment, PSCI)的关系。方法 选取2019年3月-2021年3月在本院静脉溶栓治疗的急性PACI患者127例为研究对象，记录溶栓再通及治疗后12个月内PSCI发生情况，分析血清S100β蛋白、8-OHDG,Lp-PLA2水平与溶栓再通及PSCI发生的关系，并进一步采用Logistic逐步回归分析溶栓再通及PSCI发生的影响因素，并绘制受试者工作特征(Receiver operati...
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| 关 键 词： | S100β蛋白 8-羟基脱氧鸟苷酸 脂蛋白相关磷脂酶A2 部分前循环供血区梗死 静脉溶栓 认知功能障碍 |
Relationship between serum S100β protein, 8-OHDG,LP-PLA2 levels and rt-PA intravenous thrombolytic recanalization and cognitive impairment after stroke in patients with acute partial anterior circulation cerebral infarction |
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| Zhang Chi,Li Hao,Zhang Shuxia,et al..Relationship between serum S100β protein, 8-OHDG,LP-PLA2 levels and rt-PA intravenous thrombolytic recanalization and cognitive impairment after stroke in patients with acute partial anterior circulation cerebral infarction[J].Stroke and Nervous Diseases,2023,30(1):19-25. |
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| Authors: | Zhang Chi Li Hao Zhang Shuxia |
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| Affiliation: | *Department of Neurology, Tangshan Hongci Hospital Limited Company, Tangshan 063000 |
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| Abstract: | ObjectiveTo observe the changes of serum S100β protein, 8-hydroxydeoxyguanodic acid(8-OHDG), lipoprotein associated phospholipase A2(LP-PLA2)levels in patients with acute partial anterior circulation cerebral infarction(PACI), and to analyze the relationship between the levels of each indicator and the efficacy of intravenous throbolysis of RT-PA and cognitive impairment after stroke(PSCI)within 12 months.Methods A total of 127 patients with acute PACI who received intravenous thrombolytic therapy from March 2019 to March 2021 were adimtted to the study subjects, and to record the occurrence of PSCI within 12 months after thrombolytic recanalization and treatment. To analyze the relationship between serum levels of S100β protein, 8-OHDG and LP-PLA2 and the occurrence of thrombolytic recanalization and PSCI, and the influencing factors of thrombolytic recanalization and PSCI were further analyzed by Logistic stepwise regression, and the receiver operating characteristic(ROC)curve was plotted to evaluate the early prediction efficiency.Results In acute PACI patients, 96 patients(75.59%)were recanalized 24 h after RT-PA intravenous thrombolysis, and 31 patients(24.41%)were not recanalized. The time from onset to thrombolysis, NIHSS score before thrombolysis and serum S100β protein, 8-OHDG and LP-PLA2 levels were independent risk factors for non-recanalization of venous thrombolysis in PACI(P<0.05). PSCI occurred in 50 patients(39.37%)and did not occur in 77 patients(60.63%)within 12 months after intravenous thrombolytic therapy. FAZEKAS score, no recanalization after thrombolytic therapy, NIHSS score and serum S100β protein, 8-OHDG and LP-PLA2 levels at 7 days after thrombolytic therapy were independent risk factors for PSCI within 12 months after intravenous thrombolytic therapy for PACI(P<0.05). NIHSS score, time from onset to thrombolytic therapy, FAZEKAS score and other basic clinical parameters combined with serum S100β protein, 8-OHDG, LP-PLA2 predicted the occurrence of PSCI within 12 months after intravenous thrombolytic therapy and PACI were 0.889 and 0.903, respectively, significantly higher than the prediction alone, it has high clinical predictive value.Conclusion The effect of intravenous thrombolytic rT-PA and the occurrence of PSCI in patients with acute PACI are closely related to early neuroinflammation and oxidative stress response. Dynamic monitoring of serum S100β protein, LP-PLA2 and 8-OHDG levels combined with NIHSS score, FAZEKAS score and other basic clinical parameters is of great significance for early prediction of intravenous throbolysis effect of PACI and occurrence of PSCI, guiding clinical diagnosis and treatment and improving prognosis. |
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| Keywords: | S100βprotein 8-hydroxydeoxyguanylic acid Lipoprotein associated phospholipase A2 Partial anterior circulation infarction Intravenous thrombolysis Cognitive impairment |
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