尤瑞克林对急性脑梗死患者神经功能及血清细胞凋亡相关因子的影响  

EFFECTS OF URINARY KALLIDINOGENASE ON NEUROLOGICAL FUNCTION AND SERUM APOPTOSIS-RELATED FACTORS IN PATIENTS WITH ACUTE CEREBRAL INFARCTION

作　　者：赵海港 梁亚丽 ZHAO Haigang;LIANG Yali(Department of Neurology,Xuchang Central Hospital,Xuchang 461000,China)

机构地区：[1]许昌市中心医院神经内科,河南许昌4610001 [2]许昌市中心医院重症监护室,河南许昌4610001

出　　处：《精准医学杂志》2019年第5期455-459,共5页Journal of Precision Medicine

基　　金：河南省医学科技攻关计划项目(201504078)

摘　　要：目的探讨尤瑞克林对急性脑梗死(ACI)患者的疗效及其对神经功能、细胞凋亡相关因子的影响。方法选择2017年1月—2018年8月我院收治的ACI患者113例,患者于发病后72 h内入院,随机分为对照组53例和观察组60例。对照组患者接受常规治疗,观察组患者在此基础上静脉滴注尤瑞克林治疗,所有患者均连续治疗14 d。治疗第14天时比较两组患者的临床疗效,同时比较两组患者治疗前后美国国立卫生院脑卒中量表(NIHSS)评分、改良的Rankin量表(mRS)评分及血清脑源性神经营养因子(BDNF)、胶质细胞源性神经营养因子(GDNF)、B淋巴细胞瘤-2(Bcl-2)、细胞色素C(Cyt C)水平的变化。结果分组对患者NIHSS评分和mRS评分有明显影响(F组间=7.454、11.294,P<0.05);且在治疗第14天时,观察组患者NIHSS和mRS评分均低于对照组(F=3.731、7.256,P<0.05)。分组对患者血清Bcl-2、BDNF、GDNF有明显影响(F组间=5.018~17.985,P<0.05);且在治疗以后第14天时,观察组患者血清Bcl-2、BDNF、GDNF水平高于对照组,而Cyt C水平低于对照组(F=2.624~18.162,P<0.05)。治疗第14天时,两组患者临床疗效比较,差异有显著性(Z=-3.196,P<0.05);另外观察组患者的治疗总有效率高于对照组(χ^2=11.402,P<0.05)。结论尤瑞克林可以明显减轻急性脑梗死患者的神经功能缺失症状,其机制可能与抑制神经细胞凋亡有关。Objective To investigate the effects of urinary kallidinogenase on neurological function and apoptosis-related factors in patients with acute cerebral infarction(ACI).Methods From January 2017 to August 2018,a total of 113 patients with ACI admitted to our hospital within 72 h after onset were enrolled and randomly divided into control group(n=53)and observation group(n=60).Patients in the control group received conventional treatment,while patients in the observation group were treated with intravenous infusion of urinary kallidinogenase in addition to the treatment for the control group.All patients were treated for 14 consecutive days.On the 14th day of treatment,the two groups were compared in terms of clinical outcome,as well as the changes in National Institute of Health Stroke Scale(NIHSS)score,the modified Rankin Scale(mRS)score,serum brain-derived neurotrophic factor(BDNF),glial cell line-derived neurotrophic factor(GDNF),B cell CLL/lymphoma-2(Bcl-2),and cytochrome C(Cyt C)after treatment.Results Group dividing had a significant effect on NIHSS score and mRS score(F intergroup=7.454,11.294,P<0.05)and serum Bcl-2,BDNF,and GDNF levels(F intergroup=5.018-17.985,P<0.05).On the 14th day of treatment,compared with the control group,the observation group had significantly lower NIHSS score and mRS score(F=3.731,7.256,P<0.05),as well as significantly higher serum Bcl-2,BDNF,and GDNF levels and a significantly lower Cyt C level(F=2.624-18.162,P<0.05).The clinical outcome was significantly different between the two groups(Z=-3.196,P<0.05),and the observation group had a significantly higher overall response rate than the control group(χ^2=11.402,P<0.05).Conclusion Urinary kallidinogenase can significantly alleviate the symptoms of neurological deficits in patients with acute cerebral infarction,possibly by inhibiting neuronal apoptosis.

关 键 词：脑梗死 组织激肽释放酶类 脑源性神经营养因子 胶质细胞源性神经营养因子 原癌基因蛋白质C-BCL-2 细胞色素C类 神经元 细胞凋亡 

分 类 号：R743.33[医药卫生—神经病学与精神病学]