丹参酮胶囊对缺血性卒中患者内质网应激信号通路相关基因表达水平、神经功能缺损程度及预后的影响  

Effects of Tanshinone Capsules on the Expression Level of Genes Related to Endoplasmic Reticulum Stress Signaling Pathway,Degree of Neurological Deficit and Prognosis in Patients with Ischemic Stroke

作　　者：周利飞 刘贺 冯鹏超 王晓玙 高永超 ZHOU Lifei;LIU He;FENG Pengchao;WANG Xiaoyu;GAO Yongchao(Department of Neurology,the Second Affiliated Hospital of Hebei North University,Zhangjiakou 075100,China;Acupuncture and Moxibustion Department,the Second Affiliated Hospital of Hebei North University,Zhangjiakou 075100,China)

机构地区：[1]河北北方学院附属第二医院神经内一科,河北省张家口市075100 [2]河北北方学院附属第二医院针灸科,河北省张家口市075100

出　　处：《实用心脑肺血管病杂志》2025年第4期117-122,共6页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：河北省中医药管理局科研计划项目(2024325)。

摘　　要：目的 探讨丹参酮胶囊对缺血性卒中(IS)患者内质网应激(ERs)信号通路相关基因表达水平、神经功能缺损程度及预后的影响。方法 本研究为随机、双盲、安慰剂对照的临床试验。选取2022-02-01至2023-08-30河北北方学院附属第二医院收治的100例IS患者为研究对象。使用自动集中随机化系统生成随机化代码,然后按照1∶1比例将患者随机分为丹参酮组(n=50)和安慰剂组(n=50)。两组患者均接受抗血栓、抗血小板或抗凝治疗,在此基础上,丹参酮组患者口服丹参酮胶囊,安慰剂组患者口服安慰剂胶囊,两组患者均持续治疗3个月。比较两组治疗前、治疗3个月ERs信号通路相关基因[配对盒蛋白5(PAX5)、内质网蛋白29(ERP29)、葡萄糖调节蛋白78(GRP78)、蛋白质二硫键异构酶家族A成员6(PDIA6)]mRNA相对表达量、美国国立卫生研究院卒中量表(NIHSS)评分及其差值,治疗3个月患者预后指标(功能独立和卒中复发情况)。IS患者ERs信号通路相关基因mRNA相对表达量差值与NIHSS评分差值的相关性分析采用Spearman秩相关分析。比较功能独立患者与非功能独立患者治疗前、治疗3个月ERs信号通路相关基因mRNA相对表达量及其差值。结果 治疗3个月,丹参酮组PAX5、ERP29、PDIA6 mRNA相对表达量低于安慰剂组(P<0.05);丹参酮组PAX5、PDIA6 mRNA相对表达量差值大于安慰剂组(P<0.05)。丹参酮组治疗3个月NIHSS评分低于安慰剂组,NIHSS评分差值大于安慰剂组,功能独立者占比高于安慰剂组(P<0.05)。Spearman秩相关分析结果显示,IS患者PAX5、PDIA6 mRNA相对表达量差值均与NIHSS评分差值呈正相关(P<0.001)。功能独立患者治疗3个月PAX5、PDIA6 mRNA相对表达量低于非功能独立患者,PAX5、PDIA6 mRNA相对表达量差值大于非功能独立患者(P<0.05)。结论 丹参酮胶囊可降低IS患者PAX5、PDIA6基因表达水平,减轻神经功能缺损程度,改善患者预后;PAX5、PDIA6基因表�Objective To explore the effects of tanshinone capsules on the expression level of genes related to endoplasmic reticulum stress(ERs)signaling pathway,degree of neurological deficit and prognosis in patients with ischemic stroke(IS).Methods This study was a randomized,double-blind,placebo-controlled clinical trial.One hundred IS patients admitted to the Second Affiliated Hospital of Hebei North University from 2022-02-01 to 2023-08-30 were selected as research subjects.Randomization codes were generated using an automated centralized randomization system,and then patients were randomly divided into the tanshinone group(n=50)and the placebo group(n=50)in a 1:1 ratio.Patients in both groups received antithrombotic,antiplatelet,or anticoagulant therapy.On this basis,patients in the tanshinone group received oral tanshinone capsules,and patients in the placebo group received oral placebo capsules,and patients in both groups continued to be treated for 3 months.The mRNA relative expression of genes related to ERs signaling pathway[paired box protein 5(PAX5),endoplasmic reticulum protein 29(ERP29),glucose regulated protein 78kD(GRP78),protein disulfide isomers family A,member 6(PDIA6)],the National Institute of Health Stroke Scale(NIHSS)scores,and their differences were compared between the two groups before treatment and at 3 months of treatment.Prognostic indicators(functionally independence and stroke recurrence)in patients at 3months of treatment.The correlation between the difference of mRNA relative expression of genes related to ERs signaling pathway and the difference of NIHSS score in IS patients was analyzed by Spearman rank correlation analysis.The mRNA relative expression of genes related to ERs signaling pathway and their differences were compared between patients with functionally independent and patients with non-functionally independent before treatment and at 3 months of treatment.Results At 3 months of treatment,the mRNA relative expression of PAX5,ERP29,and PDIA6 in the tanshinone group was lower tha

关 键 词：缺血性卒中 丹参酮胶囊 内质网应激 神经功能 预后 随机对照试验 

分 类 号：R743.3[医药卫生—神经病学与精神病学]