急性脑梗死及脑出血患者应激状态下肠黏膜屏障功能变化  

Early Changes of Intestinal Mucosal Barrier Function in Patients With Acute Cerebral Infarction and Cerebral Hemorrhage

作　　者：陈巍巍[1] 刘芷含[2] 张侠[1] 黄文娟[1] 谢志远[3] 孙慧勤[1] 

机构地区：[1]徐州市中心医院神经内科,江苏徐州221000 [2]徐州医学院附属医院神经内科,江苏徐州221000 [3]徐州市中心医院胃肠外科,江苏徐州221000

出　　处：《中国继续医学教育》2016年第32期99-100,共2页China Continuing Medical Education

摘　　要：目的 研究急性脑梗死、脑出血患者发病早期肠道屏障功能随病程进展的变化。方法 选取2013年9月-2015年12月徐州市中心医院神经内科,并确诊为急性脑梗死、脑出血的患者67例,分别于不同时间点取静脉血（12 h内、24 h、72 h、1周、3个月）。同时选取同期门诊健康体检者54例作为对照组,检测其血浆D-乳酸（D-LAC）、二胺氧化酶（DAO）水平。结果 （1）与正常对照组相比,急性脑梗死、脑出血患者在发病后均出现肠黏膜屏障功能改变,且脑梗死、脑出血组患者在发病24h后较发病初期（12 h内）D-LAC、DAO水平逐渐升高,72 h达到高峰,随后1周血清D-LAC及DAO持续高水平（P〈0.05）;（2）在发病12 h内、24 h、72 h、1周、3个月5个时间段内脑梗死、脑出血患者两组间的D-LAC、DAO水平对比,差异无统计学意义（P〉0.05）。结论 脑梗死及脑出血患者急性期应激状态下均会出现肠黏膜屏障功能的改变,且两者在相同发病时间段内无显著差异。Objective To explore the changes of intestinal barrier function in patients with acute cerebral infarction and cerebral hemorrhage in the early stage.Methods 67 cases of patients with acute cerebral infarction and cerebral hemorrhage were enrolled in department of neurology from September 2013 to December 2015. Blood samples were taken from these patients at different time points（within 12 h, 24 h, 72 h, 1 week, 3 months）. At the same time, D-LAC and DAO levels were measured in 54 cases of patients with outpatient physical examination during the same period as control to compare the changes of intestinal function in the patients.Results Compared with the normal control group, acute cerebral infarction, cerebral hemorrhage occurred after the change in the incidence oifntestinal mucosal barrier function, and cerebral infarction, cerebral hemorrhage group after the onset of 24 h compared with the onset of the early （12 h） D-LAC, DAO levels gradually increased, then increased gradually, reached the peak at 72 h, followed by 1 weeks of sustained high level of serum D-LAC and DAO （P 〈0.05）. （2） D-LAC, DAO levels of patients with cerebral infarction and cerebral hemorrhage in different Onset time （within 12 h, 24 h, 72 h, 1 week, 3 months） had no significant difference （P 〉 0.05）.Conclusion Both of patients with cerebral infarction and cerebral hemorrhage at acute phase of stress state appear the changes of intestinal mucosal barrier function, and there was no signiifcant difference between two groups in the same period of time.

关 键 词：脑梗死 脑出血 肠黏膜屏障 DAO D-LAC 

分 类 号：R642[医药卫生—外科学]