胰岛素样生长因子-Ⅰ在急性进展性脑梗死中的水平及临床意义

目的通过对进展性脑梗死患者的前瞻性研究,检测胰岛素样生长因子-Ⅰ的水平,探讨其在进展性脑梗死中的作用。方法选择30例健康体检者作为正常对照组,选择78例发病48 h以内的急性期脑梗死患者,包括进展组22例、稳定组56例,均为sss评分系统及颅脑CT确诊。所有入选病例均于发病48 h及30 d时,采血3 mL,采用平衡饱和竞争放射免疫分析法测定血浆IGF-Ⅰ变化,同时测定脑梗死体积。结果进展组血浆IGF-Ⅰ（10.4±1.6）ng/mL,明显低于稳定组（12.9±2.3）ng/mL,两组比较有统计学差异（P〈0.05）,而对照组为（28.2±7.8）ng/mL。进展组与稳定组于发病30 d时测血浆IGF-Ⅰ均有上升,接近于正常范围。结论脑梗死发生早期,作为神经保护剂的胰岛素样生长因子-Ⅰ合成水平下降提示神经功能受损严重,可能提示病情进展,可作为脑梗死进展的预测指标。

The signifficance of insulin-like growth factor-I on acute progressive cerebral infarction.

Objective To determine the possible mechanisms of acute progressive cerebral infarction（APCI）,insulin-like growth factor-Ⅰ in patients with APCI.Methods Thirty healthy persons were taken as control group in the study.Seventy-eight patients with cerebral infarction who were admitted to our hospital within 48 hours after ictus were studied,included the progressive cerebral infarction group（22 cases）and the stable group（56 cases）.All of the patients with cerebral infarction were matched with diagnosis by clinical standards referred to the fourth national cerebrovascular diseases meeting in 1995 and were confirmed by computerized tomogramphy（CT）.We phlebotomized 3ml,adopted balance saturation compete radio immunoassay to measure the content of IGF-Ⅰ in serum through three groups,and obtained the infarction volume.Results Serum IGF-Ⅰ levels of the progressive group on admission was（10.4±1.6）ng/mL,which was far lower than（12.9±2.3）ng/mL in the stable group,there was significant difference between two groups（P〈0.05）.It was（28.2±7.8）ng/mL in the control group.Conclusion Insulin-like growth factor-Ⅰ（IGF-Ⅰ）is the neurological protection.It decreases early,indicates that the patients’neurological function is destroyed seriously which may be a predictor of progressive cerebral infarction.