短暂性脑缺血发作患者认知能力与血清神经肽的关系研究  

Research on cognitive ability and serum neuropeptide in patients with transient ischemic attack

作　　者：张桂莲[1] 李觉慧[2] 张茹[1] 刘璟洁[1] 卜宁[1] 姚丽[1] 杜赟[1] 王学良[3] 吴海琴 

机构地区：[1]西安交通大学医学院第二附属医院神经内科,710004 [2]西安市儿童医院 [3]西安交通大学医学院公共卫生系,710004

出　　处：《卒中与神经疾病》2008年第1期9-11,14,共4页Stroke and Nervous Diseases

摘　　要：目的通过观察65例短暂性脑缺血发作(TIA)患者的认知能力、血清促红细胞生成素(EPO)、神经元特异性烯醇化酶(NSE)及亮氨酸-脑啡肽(L-EK)水平变化,以探讨以上神经肽、TIA发作次数与认知障碍的关系。方法选择最后1次发作在72h内的TIA患者,按照中国卒中量表(CSS)于入院当天进行现场或回顾性神经功能缺损程度评分,根据简易智力状态量表(MMSE)对患者组及对照组的认知能力进行测评;采用放免法测定血清神经肽EPO、NSE、L-EK水平,分析各种神经肽、TIA发作次数与患者认知能力的关系。结果患者组的MMSE明显低于对照组(P<0.01);患者组血清EPO、NSE、L-KE水平均明显高于对照组(P分别<0.05,0.01,0.05),且在不同认知能力损害组血清L-EK、NSE水平存在显著差异;不同发作次数的TIA患者MMSE及CSS明显不同。结论观察TIA的发作次数及测定TIA患者血清L-EK及NSE水平可能对判断患者认知障碍程度具有重要价值。Objective Observing the cognitive ability and serum Erythropoietin(EPO),Neuron-specific enolase(NSE)and Leucine-enkephalin(L-EK)in the intermittent period in 65 TIA patients,discussing the possible effect of these neuropeptides and TIA frequencies on the changes of cognitive ability.Methods Chose patients with the final attack of TIA within 72 hours,including cases group(65 patients with TIA)and control group.The temporal or retrospective evaluation of neural function deficit were carried in cases group by Chinese stroke scale(CSS)on the day they came to hospital.And the cognitive ability was measured by Mini-mental state examination(MMSE)in cases and controls.EPO,NSE and L-EK in serum were measured by Radioimmunoassay(RIA)when they came to hospital after fasting 10 hours.The relationship between TIA frequencies,the level of EPO,NSE,L-EK and cognitive ability was analyzed.Results The score of MMSE was significantly lower in cases than in controls(t=2.995,P<0.01);The level of EPO,NSE,L-KE were significantly higher in cases group(P<0.05,0.01,0.05 respectively);And the level of L-EK,NSE was significantly different among 3 groups of cognitive ability disturbance.With the difference in frequencies of TIA,the score of MMSE and CSS were obviously different.The more frequencies of TIA,the more severe impairment both the cognitive ability and the clinic neural function.Conclusions Cognitive dysfunction exists in the patients with TIA.The cognitive dysfunction caused by TIA could be evaluated by the TIA frequencies,L-EK and NSE in the intermittent period of TIA.

关 键 词：短暂性脑缺血发作 认知障碍 神经肽 

分 类 号：R743[医药卫生—神经病学与精神病学]