急性脑梗死患者血神经肽Y与一氧化氮合酶的关系  

Relationship between plasma neuropeptide Y and serum nitricoxide synthase for patients with acute cerebral infarction

作　　者：秦文玲[1] 曹红[1] 谷玲[1] 王琪[1] 朱鸿[1] 

机构地区：[1]大连医科大学附属第一医院神经内科,辽宁省大连116011

出　　处：《中华急诊医学杂志》2010年第12期1249-1252,共4页Chinese Journal of Emergency Medicine

摘　　要：目的 观察急性脑梗死（ACI）患者血浆神经肽Y（NPY）、血清一氧化氮合酶（NOS）水平的动态变化,探讨二者的关系及其临床意义.方法 采用前瞻性对照研究的方法.脑梗死（CI）组为大连医科大学附属一院神经科2008年5月至2009年3月的住院患者,共30例（男21例,女9例）,年龄（58.07±12.15）岁.首次发病,病程48 h以内,符合中华神经科学会及中华神经外科学会1996年制定的脑梗死诊断标准.排除半年内患急性心肌梗死、周围血管病、感染、肿瘤、严重脏器功能障碍等疾病.对照组均为同期健康体检者,共27例（男15例,女12例）,年龄（55.00±11.03）岁.两组具有可比性.采集对照组及CI组（发病48 h内和病后10 d）空腹肘静脉血,用放免法检测NPY水平,化学比色法检测NOS水平.计算责任梗死灶体积,应用美国国立卫生研究院卒中量表（NIHSS）进行神经功能缺失程度评定.样本间的构成比采用x2检验,组间差别的分析采用t检验,双变量间单因素相关分析采用直线相关分析.结果 ①NPY水平两组差异无统计学意义（P＜0.05）.②结构型NOS（cNOS）水平发病48 h内比对照组显著降低,与梗死体积、同期NIHSS评分呈显著负相关（P＜0.05）,与NIHSS评分的差值呈显著正相关（P＜0.05）.病后10 d比发病48 h内显著升高.③诱导型NOS（iNOS）水平发病48 h内比对照组显著升高（P＜0.05）,与梗死体积、同期NIHSS评分呈显著正相关（P＜0.05）,与NIHSS评分的差值呈显著负相关（P＜0.05）.病后10 d比发病48 h内显著降低（P＜0.05）.④CI组NPY水平与cNOS,iNOS水平没有显著相关（P＜0.05）.NPY水平的差值与cNOS水平的差值呈显著负相关（P＜0.05）.结论 ACI患者血浆NPY水平变化不显著,与病情无明显相关.发病48 h内血清cNOS水平与病情呈显著负相关,iNOS水平与病情呈显著正相关,其水平可以反应CI的严重程度.发病48 h内和病后10 d血浆NPY水�Objective To observe the dynamic changes in plasma levels of neuropeptide Y （NPY） in patients with acute cerebral infarction （ACI） and the serum nitric oxide synthase （NOS） in order to find out the relationship between each other as well as their clinical significance. Method A prospective and control study was done in 30 patients with ACI including 21 male and 9 female with average age of （58.07 ± 12. 1S） years admitted from May 2008 to March 2009. These patients hit the diagnostic criteria for cerebral infarction （CI） set by the Chinese Society for Neruoscience and the Chinese Association of Neurosurgery in 1996 for their first attack of CI was treated within 48 hours. Patients with acute myocardial infarction, peripheral vascular disease, infection, tumor,or severe organic functional impairment, etc within six months were excluded. Another 27 healthy subjects asking for routine physical examination including 15 male and 12 female with average age of （55.00± 11.03） years were included as control group at the same period. The two groups were comparable. The blood samples of fasted subjects of control group and CI patients 48 hours after and within 10 days after attack were taken to examine the level of NPY by using radioimmunoassay and the level of serum NOS by using chemical colorimetry. The size of responsible focus of CI was calculated, and the degree of neurological deficits were estimated with Stroke Scales set by the American National Institutes Of Health （NIHSS）. The chi-square test was used for constituent ratios within samples, while t -test was applied to analysis of differences between two groups, and linear was used for bivariate simple correlation analysis. Results （1） There was no significant difference in NPY between two groups. （2） The level of constructional NOS （cNOS） within 48 hours after attack in CI group was significantly lower than that in control group, and it was significantly and negatively correlated with the size of infarction and the NIHSS sc

关 键 词：急性脑梗死 神经肽Y 结构型一氧化氮合酶 诱导型一氧化氮合酶 梗死体积 NIHSS评分 

分 类 号：R743.33[医药卫生—神经病学与精神病学]