脑梗死血清髓鞘碱性蛋白水平与TOAST分型相关性  

The Correlation between Serum Myelin Basic Protein Contents in Acute Cerebral Infarction and TOAST Classification

作　　者：戚艳红 刘刚[1] 沈雪 肖璐 张娴娴 杨璞 朱艳 陈应柱 

机构地区：[1]扬州大学临床医学院神经内科,江苏省扬州市225001

出　　处：《中华全科医学》2012年第11期1672-1673,1676,共3页Chinese Journal of General Practice

基　　金：江苏省中医药管理局课题(LB09126)

摘　　要：目的观察不同类型急性脑梗死(ACI)患者血清髓鞘碱性蛋白(MBP)水平变化及其与预后的关系。方法采用ELISA法检测384例连续收住入院、发病在3 d内的ACI患者血清MBP水平,并按照急性卒中治疗低分子肝素试验(TOAST)分型标准分为5大亚型,分析TOAST各亚型MBP水平变化及其与改良Rankin评分(mRS)的相关性。结果TOAST各亚型构成比依次为大动脉粥样硬化型(LAA)35.16%、小动脉闭塞型(SAO)21.09%、心源性栓塞型(CE)17.19%、其他明确病因型(SDE)16.41%、不明原因型(SUE)10.15%。CE、LAA、SUE亚型MBP水平较对照组升高、SAO亚型变化不明显。与对照组比较,LAA、CE亚型MBP水平差异具有统计学意义(P<0.01)。LAA、CE预后不良率高,SAO、SUE预后良好率高。结论 MBP随TOAST亚型不同而异,发病后血清MBP可以作为急性脑梗死患者预后判断的指标之一。Objective To investigate pattern of fluctuations and clinical significance of myelin basic protein （MBP） levels in patients with different subtypes of acute cerebral infarct and its relationship with the score of mRS. Methods MBP was measured in 384 ACI patients by ELISA. All of the ACI patients were divided into 5 groups according to the Trial of Org 10172 in Acute Stroke Treatment（TOAST） criteria. And then the relationship between MBP level and NIHSS score in different TOAST subtypes were analyzed. Results The percentage of each ischemic stroke TOAST subtype was as follows：large-artery atherosclerosis 35.16% , small-vessel occlusion 21.09% , cardioembolism 17.19% , stroke of other determined etiology 16.41% , stroke of unde- termined etiology 10.15%. The serum level of MBP in cardioembolism,large-artery atherosclerosis and stroke of undetermined e- tiology subtypes increased after cerebral infarction,the serum level of MBP of small-vessel occlusion subtype didn＇ t change signif- icantly. In comparison with the control group, the serum levels of MBP in LAA and CE had significant differences （P 〈 O. 01 ）. Conclusion Different classifications had different serum levels of MBP. There was a positive correlation between MBP and mRS. The serum level of MBP was related to the severity of the state of cerebral infarction to some degree.

关 键 词：髓鞘碱性蛋白 改良Rankin评分 急性脑梗死 急性卒中治疗低分子肝素试验 

分 类 号：R743.33[医药卫生—神经病学与精神病学]