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急性脑梗死患者髓鞘碱性蛋白动态检测的临床意义
引用本文:陈俊 何国厚 黎华 余绍祖. 急性脑梗死患者髓鞘碱性蛋白动态检测的临床意义[J]. 郧阳医学院学报, 2005, 24(2): 77-79
作者姓名:陈俊 何国厚 黎华 余绍祖
作者单位:郧阳医学院附属太和医院神经内科,郧阳医学院附属太和医院神经内科,郧阳医学院附属太和医院神经内科,武汉大学医学院附属人民医院神经内科 湖北十堰442000,湖北十堰442000,湖北十堰442000
摘    要:
目的动态观察急性脑梗死患者(acutecerebralinfarction,ACI)血浆中髓鞘碱性蛋白(myelinbasicpro tein,MBP)的变化,探讨其与脑梗死体积、神经功能缺损程度、梗死部位等方面相关性。方法该实验采用酶联免疫吸附法(enzyme-linkedimmunosorbentassay,ELISA)对50例急性脑梗死患者的血浆MBP水平进行动态检测,并与30例对照组患者进行比较,同时应用NIHSS进行神经功能缺损评分及CT扫描测定梗死体积,并应用SPSS11.5统计软件包进行统计学分析。结果急性脑梗死患者MBP浓度在发病早期开始升高,明显高于恢复期及对照组,有严重神经功能缺失的患者MBP升高更明显,MBP>10.0μg/L、NIHSS12分均提示患者预后不良;MBP的血浆浓度与梗死体积呈显著正相关(P<0.01),与神经功能缺损程度也呈显著正相关(P<0.01)。结论缺血性脑梗死后血浆中MBP的出现与髓鞘损伤有关,并通过受损的血脑屏障进入血液,MBP可作为缺血性脑损伤的外周标志物,对指导治疗有帮助。

关 键 词:脑梗死  髓鞘碱性蛋白  梗死体积  NIHSS
文章编号:1006-9674(2005)02-0077-03
修稿时间:2005-03-11

The Clinical Value of Serial Determination of Myelin Basic Protein in Patients with Acute Cerebral Infarction
CHEN Jun,HE Guo-hou,LI Hua,et al.. The Clinical Value of Serial Determination of Myelin Basic Protein in Patients with Acute Cerebral Infarction[J]. Journal of Yunyang Medical College, 2005, 24(2): 77-79
Authors:CHEN Jun  HE Guo-hou  LI Hua  et al.
Abstract:
Objective The study aimed to evaluate the significance of serial changes of myelin basic protein concentrations in plasma from patient with acute cerebral infarction and to find the correlation with neurologic deficits ,infarct volume and infarct spot ,also with sex and age. Metheds: MBP plasma levels were serially determined in 50 patients with ACI and in 30 control subjects. Assays were performed by using ELISA. The neurological status was evaluated by the NIHSS and the cranial CT also serially performed to calculate infarct volume. Comparison analysis were performed by using a SPSS 11.5 statistical package. Results The concentrations of MBP were higher in patients with ACI;the MBP concentrations in plasma were significantly higher in patients with severe neurological deficits at adimission. When MBP>10.0μg/L or NIHSS>12 point indicating poor outcome; The release of MBP in patients was associated with the volume of brain lesions (P<0.01) and the neurological outcome as assessed by NIHSS (P<0.01). Conclusions Presence of MBP in plasma after ischemic stroke may be due to combined leakage out of myelin and passage through an impaired brain-blood barrier, indicating severe ischemic injury ,therefore MBP in plasma can be used as a peripheral marker of ischemic focal brian damage,may be helpful for therapeutic decisions in acute ischemic stroke.
Keywords:cerebral infarction  myelin basic protein  infarct volume  NIHSS
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