两种血清标志物和脑电图与急性脑梗死患者病灶体积及神经功能的相关性研究  

Correlation of two serum markers and electroencephalogram with infarct size and neurological function in patients with ACI

作　　者：丁洁[1] 黄健康 文洪波 汪捷 丁朋雨 王鹏 Ding Jie;Huang Jiankang;Wen Hongbo;Wang Jie;Ding Pengyu;Wang Peng(Department of Neurology,Nanjing Lishui People's Hospital·Lishui Branch of Zhongda Hospital Southeast University,Nanjing211200,Jiangsu Province,China)

机构地区：[1]南京市溧水区人民医院(东南大学附属中大医院溧水分院)神经内科,211200

出　　处：《中华老年心脑血管病杂志》2025年第1期68-71,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：南京市溧水区人民医院引进人才科研启动基金项目(2021YJ10)。

摘　　要：目的探讨急性脑梗死(acute cerebral infarction,ACI)患者脑电图、血清胰岛素生长因子1(insulin-like growth factor 1,IGF-1)、神经元特异性烯醇化酶(neuron-specific enolase,NSE)与病灶体积及美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分的关系。方法选择2021年8月至2022年12月在南京市溧水区人民医院神经内科首次确诊的ACI患者218例,根据病灶体积分为大体积组63例、中体积组103例和小体积组52例。检测患者脑电图(δ+θ)与(α+β)功率比[(δ+θ)/(α+β)ratio,DTABR]、大脑对称指数(brainspine interface,BSI)、血清IGF-1和NSE水平,观察上述指标与MRI检查脑梗死病灶体积、NIHSS评分、阿替普酶溶栓后2周、4周时NIHSS评分的相关性。结果中体积组和大体积组IGF-1水平明显低于小体积组,NSE、DTABR、BSI明显高于小体积组(P<0.05);大体积组IGF-1水平明显低于中体积组,NSE、DTABR、BSI明显高于中体积组(P<0.05)。DTABR、BSI、血清NSE与病灶体积(r=0.563,P=0.000;r=0.318,P=0.038;r=0.673,P=0.000)和治疗前NIHSS评分(r=0.499,P=0.000;r=0.362,P=0.013;r=0.750,P=0.001)呈显著正相关。血清IGF-1水平与病灶体积(r=-0.572,P=0.000)和治疗前NIHSS评分(r=-0.438,P=0.001)呈显著负相关。DTABR、BSI、血清NSE、病灶体积均与溶栓后2、4周NIHSS评分呈正相关,IGF-1与溶栓后2、4周NIHSS评分呈负相关(P<0.05,P<0.01)。结论ACI患者脑电图、IGF-1和NSE与病灶体积和溶栓后NIHSS评分显著相关。Objective To explore the relationship of EEG and IGF-1and NSE with infarct size and NIHSS score in patients with acute cerebral infarction(ACI).Methods A total of 218patients with freshly diagnosed ACI admitted in our department from August 2021to December 2022were enrolled,and according to the lesion volume,they were divided into large-,medium-and smallvolume groups(63,103and 52cases,respectively).The(δ+θ)/(α+β)ratio(DTABR),brainspine interface(BSI),and serum IGF-1and NSE levels were measured in these patients.The correlation of the above indicators with the volume of infarct volume by MRI,and NIHSS score at baseline and at 2and 4weeks after rt-PA thrombolysis was analyzed.Results The medium-and large-volume groups had significantly lower serum IGF-1level,and higher NSE level and increased DTABR and BSI values than the small-volume group(P<0.05).When compared with the medium volume group,the serum IGF-1level was obviously lower,and the NSE level and DTABR and BSI values were higher in the large-volume group(P<0.05).The DTABR and BSI values and serum NSE level were positively correlated with the infarct size(r=0.563,P=0.000;r=0.318,P=0.038;r=0.673,P=0.000)and baseline NIHSS score(r=0.499,P=0.000;r=0.362,P=0.013;r=0.750,P=0.001).The serum IGF-1level had a negative correlation with the infarct size(r=-0.572,P=0.000)and baseline NIHSS score(r=-0.438,P=0.001).In addition,positive correlations were observed in DTABR and BSI values,serum NSE level and infarct size with the 2-week and 4-week NIHSS scores,while negative correlations were seen in the serum IGF-1level with the NIHSS scores at the two time points(P<0.05,P<0.01).Conclusion EEG parameters,IGF-1and NSE are significantly correlated with infarct size and NIHSS score after thrombolysis in ACI patients.

关 键 词：脑梗死 脑电描记术 胰岛素样生长因子 病灶体积 神经元特异性烯醇化酶 

分 类 号：R743.33[医药卫生—神经病学与精神病学]