急性进展性脑梗死患者外周血清可溶性CD40配体、外周血单个核细胞胞核核因子κB表达的变化及灯盏生脉胶囊的干预作用  

Changes of sCD40L and Expressive Rate of NF-κB for Patients with Acute Progressive Cerebral Infarction and the Intervenient Role of Deng Zhan Sheng Mai

作　　者：毛德军[1] 唐咏春[1] 郭瑞友[1] 臧云华[1] 侯荣耀[1] 

机构地区：[1]青岛大学医学院附属海慈医疗集团神经内科

出　　处：《中国卒中杂志》2009年第8期656-660,共5页Chinese Journal of Stroke

摘　　要：目的探讨急性进展性脑梗死（acute progressive cerebral infarction,APCI）患者各期病程中外周血清可溶性CD40配体（serum soluble CD40ligand,sCD40L）水平及外周血单个核细胞（peripheral blood mononuclear cells,PBMC）胞核核因子κB（nuclear factor-κB,NF-κB）p65表达率的变化及灯盏生脉胶囊的干预作用。方法将起病24h以内的100例APCI患者随机分为常规组和试验组,每组各50例患者,选择同期住院的急性脑梗死患者50例作对照组,所有病例均采用常规治疗,试验组除常规治疗外还给予灯盏生脉胶囊治疗。治疗前后检测常规组和试验组患者神经功能缺损评分（China Stroke Scale,CSS）,常规组、试验组和对照组梗死灶体积、外周血清sCD40L水平及PBMC胞核NF-κB p65表达率的变化。 结果治疗后试验组患者的CSS和梗死灶体积的进展程度明显低于常规组（P〈0．05），常规组和试验组患者各期病程中外周血清sCD40L水平ELPBMC^J＆核NF-KBp65表达率均明显高于对照组（P〈O．05），试验组患者各期病程中外周血清sCD40L水平及PBMC胞核NF--KBp65表达率明显低于常规组（P〈O．05），治疗期间不良反应轻微。结论CD40-CD40L信号通路及PBMC胞核NF-KB表达的过度上调而介导的炎症、凋亡机制可能是APCI的分子生物学因素，灯盏生脉胶囊能通过下调此分子生物学因素而改善其预后。Objective To explore the peripheral serum soluble CD40 ligand（sCD40L） level and the expressive rate of nuclear factor-kB（NF-kB）p65 in peripheral blood mononuclear cells（PBMC） cellular nucleus of patients with acute progressive cerebral infarction（APCI） and the intervenient role of Deng Zhan Sheng Mai capsule in the process. Methods One hundred patients getting with acute progressive cerebral infarction less than 24h of the onset were randomly divided into routine and experimental group. Each group had fifty cases Fifty patients getting with acute cerebral infarction admitted to our hospital at the same time were selected as the control. All patients were treated under the general way; while the patients in the experimental group were given an extra intervenient treatment of Deng Zhan Sheng Mai capsule in addition to the general treatment. The change of China Stroke Scale （CSS） in routine and experimental group, the infarction focal volume, peripheral serum sCD40L level and the expressive rate of NF-rd3 p65 in PBMC cellular nucleus of patients in routine, experimental group and control were measured minutely before and after treatment. Results After treatment, the progressive degree of CSS and infarction focal volume in the experimental group were obviously lower than that in the routine group （P〈0.05）. The peripheral serum sCD40L level and the expressive rate of NF-~B p65 in PBMC cellular nucleus of patients at each course of disease were obviously higher in experimental or routine group than those in control （P〈0.05）, and the same changes of molecular biological level were obviously lower in experimental group than those in routine group （P〈0.05）. Only slight side effects occurred during the whole course of the treatment. Conelnslon The inflammatory and apoptotic mechanism mediated by excessive increase of CD40- CD40L signaling pathway and NF-kB expression in PBMC nuclear might be the progressive factors in molecular biology for patients with APCI. Deng Zhan Sheng Mai capsul

关 键 词：灯盏细辛 脑梗死 可溶性CD40配体 核因子-κB X线计算机体层摄影术 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R285[医药卫生—临床医学]