微创血肿清除术对脑出血患者髓鞘碱性蛋白及血清胶质纤维酸性蛋白的影响

目的探讨脑出血（ICH）患者微创血肿清除手术后，患者血清髓鞘碱性蛋白（MBP）及血清胶质纤维酸性蛋白（GFAP）水平的变化。方法收集ICH患者58例，采用随机数字表法分为两组，其中微创组给予微创血肿清除手术治疗，保守组给予常规内科治疗，同时随机选取30例健康人作为对照组。微创组、保守组于治疗前、治疗后1d、3d、7d、14d，对照组于纳入该研究当天抽取静脉血检测血清MBP及GFAP。结果微创组治疗总有效率为96．6％（28／29），高于保守组的79．3％（23／29）（x2=4．06，P〈0．05）。MBP水平：微创组、保守组两组治疗前与对照组差异不明显；发病后1d，其水平开始升高，与治疗前比较差异有统计学意义；治疗后7d开始下降，保守组到14d后MBP水平仍高于治疗前；治疗期间，微创组不同时间MBP水平均明显低于保守组。GFAP水平：治疗前微创组、保守组两组患者GFAP水平已明显高于对照组；治疗后两组GFAP水平持续升高，直到14d下降，仅微创组接近于正常；治疗期间，微创组不同时间GFAP水平均明显低于保守组。结论微创血肿清除术治疗ICH有比较好的效果，且可以明显降低患者血清MBP及GFAP水平。

Influnence of minimally invasive surgery of hematoma clear on myelin basic protein and serum glial fibrillary acidic protein in patients with intracerebral hemorrhage

Objective To explore the changes of serum myelin basic protein （MBP） and serum glial fibril- lary acidic protein （GFAP） in intracerebral hemorrhage （ICH） patients after minimally invasive hematoma clear sur- gery. Methods 58 ICH patients were randomly divided into two groups. Patients in minimally invasive group received minimally invasive surgery to remove the hematoma, and patients in the conservative group were given regular medical treatment. 30 healthy people were randomly selected as control group. Serum MBP and GFAP were detected in ICH patients before treatment, and 1 d,3 d,7 d, 14d after treatment. Serum MBP and GFAP were detected in healthy controls when they enrolled in the study. Results The total effective rate of the minimally invasive group was 96.6% （ 28/29 ）, which was higher than 79.3 % （ 23/29 ） of the conservative group （ X2 = 4.06, P 〈 0.05 ）. Before treatment,the MBP level among the three groups had no significant difference. 1 d after the onset of ICH, the MBP level began to rise,and had statistically significant difference compared with before treatment. 7d after treatment,the MBP level be- gan to drop, 14d after treatment, the MBP level in conservative group was still higher than before treatment. During treatment ,the MBP level in the minimally invasive group at different time points was significantly lower than conserva- tive group. Before treatment, the GFAP level in ICH patients was obviously higher than the healthy controls. After treatment, the GFAP level in ICH patients continued to rise until 14d after treatment began to decrease,the GFAP lev- el only in the minimally invasive group was close to normal. During treatment, the GFAP level in the minimally inva- sive group at different time points was significantly lower than conservative group. Conclusion Minimally invasive surgery of hematoma clear has good effect on ICH patients, and can obviously decrease the serum MBP and GFAP levels.