血脑屏障通透性与接受溶栓的急性脑梗死患者预后的相关性  

The correlation between blood-brain barrier permeability and prognosis in patients with acute cerebral infarction who received thrombolysis

作　　者：熊永波[1] 蔡燕[2] 罗军 Xiong Yongbo;Cai Yan;Luo Jun(Internal Medicine-Neurology,Yanting People's Hospital of Mianyang City,Mianyang Sichuan 621600;不详)

机构地区：[1]四川省绵阳市盐亭县人民医院神经内科,621600 [2]川北医学院附属医院检验科 [3]绵阳市四零四医院神经内科

出　　处：《卒中与神经疾病》2020年第6期747-750,共4页Stroke and Nervous Diseases

摘　　要：目的探讨血脑屏障通透性与接受溶栓治疗的急性脑梗死患者预后的相关性。方法纳入绵阳市盐亭县人民医院在2018年5月-2019年5月收治的急性脑梗死且接受溶栓治疗的患者共76例,随访3个月,根据预后情况分为预后良好组和预后不佳组,比较2组患者临床资料、实验室检查指标水平、血脑屏障通透性等。结果所有研究对象随访3个月后共有8例患者失访,其中mRs评分为良好(0~1分)共32例,为预后良好组,余为预后不佳组(2~6分)共36例;2组患者性别、BMI、梗死部位、冠心病史、高血压病史、糖尿病史、高脂血症史、脑卒中史、发病时间、吸烟史、饮酒史、家族史、应用药物、基线NIHSS评分、Cr,BUN,HDLc,LDLc,PLT,HGB,APTT,DD、空腹血糖、糖化血红蛋白水平均无明显差异(P>0.05);预后良好组患者年龄、房颤史的比例、UA水平与预后不佳组比较均有明显差异(P<0.05);2组患者AUC无明显差异(P>0.05);预后良好组患者Ktrans及VP与预后不佳组比较均有明显差异(P<0.05);进行logistics回归分析显示年龄(OR=1.190,P=0.026)、Ktrans(OR=1.104,P=0.005)为预后不佳的危险因素,VP(OR=0.556,P=0.022)为保护因素。结论血脑屏障通透性为影响接受溶栓治疗的急性脑梗死患者预后的相关因素。Objective To explore the correlation between blood-brain barrier permeability and prognosis in patients with acute cerebral infarction treated with thrombolytic therapy.Methods A total of 76 patients with acute cerebral infarction were admitted to our hospital from May 2018 to May 2019, all the patients were followed up for 3 months and were divided into good prognosis group and poor prognosis group according to their prognosis. The clinical data, test parameters, blood-brain barrier permeability of the two groups were compared and the regression analysis was conducted.Results All subjects were followed up for 3 months and 8 patients were lost to follow-up. Among them, 32 patients with the mRs score of good(0~1 points) were in the good prognosis group, while 36 patients were in the poor prognosis group(2~6 points). There was no statistically significant difference between the two groups in gender, BMI, infarction site, history of coronary heart disease, history of hypertension, history of diabetes, history of hyperlipidemia, history of stroke, onset time, history of smoking, history of drinking, family history, application of drugs, baseline NIHSS score, Cr, BUN, HDLc, LDLc, PLT, HGB, APTT, DD, FBG and Hba1 c levels(P>0.05). Age, atrial fibrillation, UA of good prognosis group had statistically significant compared with poor prognosis group(P<0.05). There was no significant difference in AUC between the two groups(P>0.05). The differences of Ktrans and VP between good prognosis group and poor prognosis group were statistically significant(P<0.05). Logistic regression analysis showed that age(OR=1.190, P=0.026) and Ktrans(OR=1.104, P=0.005) were risk factors for poor prognosis, and Vp(OR=0.556, P=0.022) was protective factor.Conclusion Blood-brain barrie permeability was a prognostic factor in patients with acute cerebral infarction treated with thrombolytic therapy.

关 键 词：急性脑梗死 溶栓治疗 血脑屏障通透性 动态增强MRI 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]