急性脑卒中患者血清IGF-1的动态变化及其临床意义

目的：了解脑卒中患者急性期血清胰岛素样生长因子-1（IGF-1）水平的动态变化及其临床意义。方法：采用放免法测定40例脑梗死、20例腔隙性梗死、40例脑出血患者起病后3d内、2周时血清IGF-1的含量，并与30例健康者对照比较。结果：脑卒中患者血清IGF-1水平明显低于对照组，脑梗死组明显低于腔隙性梗死组，相比较均有显著差异（P〈0．01），2周时血清IGF-1水平有恢复；脑出血与脑梗死患者血清IGF-1水平无统计学差异（P〉0．05）。结论：脑卒中患者急性期血清IGF-1水平可帮助判断病情轻重和预后。IGF-1可能参与了脑出血的病理过程或脑出血周边组织可能存在缺血性损害。IGF-1在急性脑卒中时也许能通过血脑屏障而产生神经保护，具有潜在的临床应用价值。

Clinical Significance of the Dynamic Changes of Serum IGF-1 Levels in Patients with Acute Cerebro-Vascular Accident

Objective To investigate the dynamic changes of serum insulin-like growth factor-1(IGF-1) levels in patients with acute cerebrovascalar accident.Methods Serum IGF-1 levels were determined with RIA in 40 patients with cerebral infarction,20 patients with lacunar infarcts and 40 patients with cerebral haemorrhage within 3days after onset and on d14 as well as in 30 controls.Results The serum IGF-1 levels in patients with cerebral vascular accidents were significantly lower than those in controls(P<0.01),the levels in patients with cerebral infarction were significantly lower than those in patients with lacunar infacts(P<0.01).On d14,levels of serum IGF-1 rose somewhat,with no difference between the levels in patients with cerebral haemorrhage and patients with cerebral infarction(P>0.05).Conclusion Serum levels of IGF-1 dropped markedly during the acute stage after cerebrovaseular accident and the magnitude might reflect the severity of the event,IGF-1 might be capable of crossing the blood-brain barrier after cerebrovascular accident and providing some protection against nerve injury,this fact might be of potential chmical applicability.