大面积脑梗死患者发病早期肠黏膜屏障功能及全身炎症反应变化研究  

Early Changes of Intestinal Mucosal Barrier Function and Systemic Inflammatory Reactions of Patients with Large-area Cerebral Infarction

作　　者：刘海燕[1] 王惠凌[1] 姜源涛[1] 王德超[1] 石佳军[1] 李强[1] 金鑫[1] 张海静[1] 

机构地区：[1]河北大学附属医院神经内科监护室,河北省保定市071000

出　　处：《实用心脑肺血管病杂志》2015年第2期28-30,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的研究大面积脑梗死患者发病早期肠黏膜屏障功能及全身炎症反应变化情况。方法选择2011年1月—2013年2月河北大学附属医院神经内科收治的脑梗死患者66例作为病例组,根据患者脑梗死情况分为大面积脑梗死组32例和一般梗死组34例;另选择同期在河北大学附属医院体检健康者30例作为对照组。检测3组受试者血清二胺氧化酶(DAO)、D-乳酸(D-LAC)、降钙素原(PCT)、C反应蛋白(CRP)、白细胞计数(WBC)、丙氨酸氨基转移酶(ALT)、肌酐(Scr)水平,并对病例组患者进行肺部感染评分(CPIS)及痰培养。结果对照组与一般梗死组血清ALT、Scr、CRP、PCT、WBC、D-LAC及DAO水平比较,差异无统计学意义(P>0.05);大面积梗死组患者血清ALT、CRP、PCT、WBC、D-LAC、DAO水平高于一般梗死组和对照组(P<0.05)。大面积梗死组CPIS及大肠埃希菌检出率高于一般梗死组(P<0.05)。结论大面积脑梗死发病早期会出现肠黏膜屏障功能损伤、全身炎症反应及肠源性感染,继而造成脏器功能受损。Objective To investigate the early changes of intestinal mucosal barrier function and systemic inflammatory reactions of patients with large-area cerebral infarction. Methods A total of 66 patients with cerebral infarction were selected as case group in the Affiliated Hospital of Hebei University from January 2011 to February 2013,and they were divided into subgroups A（ with large-area cerebral infarction,n = 32） and B（ with normal area of cerebral infarction,n = 34） according to cerebral infarction area. a total of healthy cases were selected as control group at the same time. Serum levels of diamine oxidase（ DAO）,D-lactic acid（ D-LAC）,PCT,CRP,WBC,ALT,Scr of the three groups were detected,and pulmonary infection score（ CPIS） and bacterial cultures of sputamentum of case group were observed. Results No statistically significant differences of serum levels of DAO,D-LAC,PCT,CRP,WBC,ALT,Scr was found between control group and B subgroup（ P〈0. 05）; serum levels of DAO,D-LAC,PCT,CRP,WBC,ALT of A subgroup were higher than those of control group and B subgroup（ P〈0. 05）. CPIS and detection rate of A subgroup were higher than those of B subgroup（ P〈0. 05）.Conclusion Patients with large-area cerebral infarction often appear damage of intestinal mucosal barrier function,systemic inflammatory reactions and intestinal infection,which may lead to organ function damage.

关 键 词：脑梗死 肠黏膜屏障 全身炎症反应综合征 

分 类 号：R743.34[医药卫生—神经病学与精神病学]