短暂性脑缺血发作对脑梗死患者的神经保护作用

目的:观察短暂性脑缺血发作(transient ischemic attacks, TIA)对脑梗死患者兴奋性氨基酸(excited amino acids, EAAs)含量和梗死容积的影响,研究TIA是否具有神经保护作用. 方法:选择20例行下肢手术的患者作为正常对照组;选择20例首次发作脑梗死的患者作为脑梗死组;选择有同侧TIA的首次发作脑梗死患者20例作为TIA组. 脑梗死组与TIA组患者入院后行颅脑CT确诊. 应用高效液相色谱分析(high performance liquid chromatography, HPLC)检测三组患者脑脊液(cerebrospinal fluid, CSF)及血浆中谷氨酸(Glu)、天门冬氨酸(Asp)浓度,同时测定脑梗死容积. 结果:脑梗死组血浆和CSF中Glu和Asp水平高于正常对照组(P<0.05),而TIA组血浆和CSF中Glu及Asp水平均低于脑梗死组(P<0.05). TIA组患者的梗死容积小于脑梗死组(P<0.05). 脑梗死组和TIA组血浆和CSF中EAAs含量与梗死容积的大小呈明显正相关(r=0.905, P<0.01). 结论:TIA可降低首次发作脑梗死患者血浆和CSF中EAAs的释放,减少脑梗死容积,具有神经保护作用.

Neuroprotective effect of transient ischemic attacks on cerebral infarction

AIM: To evaluate the effect of transient ischemic attacks (TIA) on cerebral infarction volume and the production of excited amino acids (EAAs) of patients with cerebral infarction. METHODS: Sixty patients including 20 patients with first ever cerebral infarction (Group CI), 20 first ever cerebral infarction patients with prior ipsilateral TIA (Group TIA) and 20 control subjects (Group control) were involved in study. Using high performance liquid chromatography (HPLC), the concentrations of glutamate and aspartate in plasma and cerebrospinal fluid (CSF) in 3 groups were measured. The cerebral infarction volume of patients in Group CI and Group TIA were evaluated. RESULTS: The levels of glutamate and aspartate in plasma and in CSF were increased in Group CI comparing with Group control ( P <0.05), and these were decreased in Group TIA comparing with Group CI ( P <0.05). The infarction volume was smaller in Group TIA than in Group CI ( P <0.05). In Group CI and Group TIA, the concentrations of glutamate and aspartate in plasma and CSF of TIA were positively correlated with infarction volume ( r =0.905, P <0.01). CONCLUSION: TIA could decreased the secretion of EAAs and the infarction volume of patients with first ever CI. TIA may have a neuroprotective effect on cerebral infarction.