P-选择素和血栓素B_(2)表达水平对不同部位缺血性脑卒中患者疗效及预后的影响研究  

Associations of P-selectin and Thromboxane B_(2) Expression Levels with Efficacy and Prognosis in Patients with Ischemic Stroke Affecting Different Parts of the Brain

作　　者：孟灿灿 程燕 焦丽艳[2] 张志伟 刘卫刚[4] 杨直堂[5] MENG Cancan;CHENG Yan;JIAO Liyan;ZHANG Zhiwei;LIU Weigang;YANG Zhitang(Clinical Medical College,Hebei University of Engineering,Handan 056000,China;Department of Dermatology,Affiliated Hospital of Hebei Engineering University,Handan 056000,China;No.1 Department of Oncology,Affiliated Hospital of Hebei Engineering University,Handan 056000,China;Department of Security,Affiliated Hospital of Hebei Engineering University,Handan 056000,China;No.3 Department of Neurology,Affiliated Hospital of Hebei Engineering University,Handan 056000,China)

机构地区：[1]河北工程大学临床医学院,河北省邯郸市056000 [2]河北工程大学附属医院皮肤科,河北省邯郸市056000 [3]河北工程大学附属医院肿瘤一科,河北省邯郸市056000 [4]河北工程大学附属医院安全保障部,河北省邯郸市056000 [5]河北工程大学附属医院神经内三科,河北省邯郸市056000

出　　处：《中国全科医学》2022年第14期1736-1740,共5页Chinese General Practice

基　　金：河北省自然科学基金资助项目(H2021402007);邯郸市科技局资助项目(19422083011-5)。

摘　　要：背景近年来,流行病学调查显示脑卒中发病人数逐年上升,成为死亡的首要原因,其中缺血性脑卒中占脑卒中的绝大多数,不同部位的梗死治疗效果及预后有所差异,血小板活化在其发生、发展中扮演了重要的角色。目的探讨P-选择素(CD62P)和血栓素B_(2)(TXB_(2))表达水平对不同部位缺血性脑卒中患者疗效及预后的影响。方法选取2019年10月至2021年6月河北工程大学附属医院神经内科收治的缺血性脑卒中患者44例,根据梗死部位不同分为前循环脑梗死组(n=23)和后循环脑梗死组(n=21),另选取同期本院体检健康者28例作为对照组。收集研究对象一般资料,并检测血常规指标。于治疗前、治疗第7天、治疗第30天,采用美国国立卫生研究院卒中量表(NIHSS)评定缺血性脑卒中患者神经功能缺损程度,酶联免疫吸附试验(ELISA)检测CD62P、TXB_(2)水平。治疗第30天,采用改良Rankin量表(mRS)评定缺血性脑卒中患者预后。结果治疗前,前循环脑梗死组和后循环脑梗死组CD62P、TXB_(2)水平均高于对照组(P<0.05)。治疗第7、30天,后循环脑梗死组NIHSS评分、CD62P、TXB_(2)水平高于前循环脑梗死组(P<0.05)。前循环脑梗死组治疗第30天mRS评分低于后循环脑梗死组(P=0.001)。结论后循环脑梗死患者CD62P、TXB_(2)水平高于前循环脑梗死患者,且疗效、预后较差,提示血小板活化水平可能在脑梗死的治疗及预后中起作用。Background Epidemiological investigations have demonstrated that the number of stroke cases is increasing recently,and stroke has become a leading cause of death.Patients affected by ischemic stroke,the most prevalent type of stroke,may have different therapeutic efficacies and prognosis if the affected parts are different,and platelet activation may play a vital role in the development of ischemic stroke.Objective To investigate the associations of P-selectin(CD62P)and thromboxane B_(2)(TXB_(2))expression levels with efficacy and prognosis in patients with ischemic stroke affecting different parts of the brain.Methods Participants were recruited from Department of Neurology,Affiliated Hospital of Hebei Engineering University from October 2019 to June 2021,including 44 neurology patients with ischemic stroke(23 with anterior circulation stroke and 21 with posterior circulation stroke),and 28 healthy physical examinees.Demographics and routine blood test indicators of all participants were collected.The National Institutes of Health Stroke Scale(NIHSS)was used to assess the degree of neurological impairment,and ELISA was used to detect the levels of CD62P and TXB_(2) of ischemic stroke patients at baseline,on the 7th and 30th days of treatment,respectively.The Modified Rankin Scale(mRS)was used to assess the prognosis of ischemic stroke patients on the 30th day of treatment.Results Before treatment,both anterior and posterior circulation stroke patients had higher mean levels of CD62P and TXB_(2) than did the physical examinees(P<0.05).On the 7th and 30th days of treatment,the mean NIHSS score,CD62P and TXB_(2) levels in posterior circulation stroke patients were higher than those of anterior circulation stroke patients(P<0.05).On the 30th day of treatment,the mean mRS score in anterior circulation stroke patients was lower than that of posterior circulation stroke patients(P=0.001).Conclusion Posterior circulation stroke patients had higher mean levels of CD62P and TXB_(2) and poorer efficacy and prognosis than d

关 键 词：缺血性脑卒中 血小板活化 P-选择素 血栓素B_(2) 治疗 预后 

分 类 号：R743[医药卫生—神经病学与精神病学]