急性脑梗死患者血浆神经肽Y与血清一氧化氮合酶水平的变化及其临床意义  

Changes and its clinical significance of plasma neuropeptide Y and serum nitric oxide synthase levels in patients with acute cerebral infarction

作　　者：秦文玲[1] 曹红[1] 谷玲[2] 王琪[3] 朱鸿[3] 

机构地区：[1]大连医科大学附属第一医院神经内科,116011 [2]大连医科大学附属第一医院核医学科,116011 [3]大连医科大学附属第一医院检验科,116011

出　　处：《临床神经病学杂志》2011年第4期258-260,共3页Journal of Clinical Neurology

摘　　要：目的探讨急性脑梗死(ACI)患者血浆神经肽Y(NPY)、血清一氧化氮合酶(NOS)水平的变化及其临床意义。方法分别用放射免疫法、化学比色法、酶法检测30例ACI患者(ACI组)(发病<48 h和第12 d)及27名正常对照者(NC组)血浆NPY、血清结构型NOS(cNOS)、诱导型NOS(iNOS)及三酰甘油(TG)水平,头颅MRI检查测量脑梗死灶体积,应用美国国立卫生研究院卒中量表(NIHSS)评定神经功能缺损程度。结果与NC组比较,ACI组NPY水平差异无统计学意义;血清cNOS水平发病<48 h显著降低(P<0.01),并与梗死体积、同期NIHSS评分呈负相关(r=-0.368、-0.457,均P<0.05),与NIHSS评分差值呈正相关(r=0.466,P<0.05);血清iNOS水平发病<48 h显著升高(P<0.01),与梗死体积、同期NIHSS评分及两次检测的血TG水平呈正相关(r=0.390、0.362、0.411、0.395,均P<0.05),与NIHSS评分差值呈负相关(r=-0.461,P<0.05)。NPY差值与cNOS差值呈负相关(r=-0.369,P<0.05)。结论 ACI患者发病后的血浆NPY水平无明显变化,但发病早期血清cNOS水平显著降低,iNOS水平显著升高。这些变化可以反映ACI的病情。Objective To observe the changes and its clinical significance of plasma neuropeptide Y （NPY） and serum nitric oxide synthase （NOS） levels in patients with acute cerebral infarction i ACI）. Methods By the methodes of radioimmunoassay, chemical colorimetry and enzymatic, the levels of plasma NPY, serum constitutive NOS （ eNOS ）, inducible NOS （iNOS） and triglyceride （TG） were detected in 30 ACI patients （ ACI group ） （onset 〈48 h and 12 d） and 27 normal controls （NC group）. The infarct volume was mesaured by skull MRI. The degree of neurologic deficit was evaluated by National Health Institute stroke scale （NIHSS）. Results Compared with NC group, the changes of plasme NPY level in ACI group had no statistically significant. The level of serum eNOS at onset 〈48 h was significant lower （P 〈 0. 01 ）, which was negatively correlated with infarct volume and NIHSS score in the same time （ r = - 0. 368, - 0. 457, all P 〈 0. 05 ） ; and it positive correlated with the difference value of NIHSS score（r =0. 466,P 〈0. 05） ; the level of serum iNOS at onset 〈48 h was significant higher （P 〈 0. 01 ）, and which was positive correlated with infarct volume, NIHSS score at same time and serum TG levels （ including times） （ r = 0. 390, 0. 362, 0. 411, 0. 395, all P 〈 0. 05 ） ; and negatively correlated with the difference value of NIHSS score （ r = - 0. 461 ,P 〈 0.05 ）. There was negatively correlated between the difference values of NPY and eNOS（ r = - 0. 369, P 〈 0. 05 ）. Conclusions The level of plasma NPY has no sighificantly change after ACI onset. But in the early stage of ACI, the serum level of eNOS is significant lower, and iNOS is significant higher. These changes can reflect the condition of ACI.

关 键 词：急性脑梗死 神经肽Y 一氧化氮合酶 

分 类 号：R743.33[医药卫生—神经病学与精神病学]