CAJ | 학술논문

目的通过观察急性颅脑损伤患者心脏功能的变化及其与血浆神经肽Y(NPY)的关系,探讨其机制. 方法选择符合诊断标准的急性颅脑损伤患者89例为观察组,根据GCS评分分成重度组(47例)和轻度组(42例);同时选取健康体检正常者35例为对照组.观察组在损伤24 h、72 h分别做超声心动图评价左心室收缩、舒张功能,并与对照组比较,同时采用放射免疫分析法检测各组血浆NPY水平. 结果急性颅脑损伤后24 h及72 h左室射血分数(EF)、每搏输出量(SV)、主动脉瓣口峰流速(AV)、每分钟心输出量(CO)、心脏指数(CI)等各心功能参数重度组与轻度组、对照组差异均有统计学意义(均P＜0.05),轻度组与对照组上述指标均无统计学意义(均P＞0.05);血浆NPY水平在轻度组与重度组间、对照组与重度组间差异均有统计学意义(均P＜0.05).经直线相关分析,血浆NPY水平升高与心功能参数变化呈负相关系(EF:r=-0.79,SV:r=-0.71,AV:r=-0.67,E/A:r=-0.63,均P＜0.01;CO:r=-0.32、CI:r=-0.35,均P＜0.05). 结论急性重度颅脑损伤患者心脏功能下降明显,且与NPY水平相关.
목적 통과관찰급성로뇌손상환자심장공능적변화급기여혈장신경태Y(NPY)적관계,탐토기궤제. 방법 선택부합진단표준적급성로뇌손상환자89례위관찰조,근거GCS평분분성중도조(47례)화경도조(42례);동시선취건강체검정상자35례위대조조.관찰조재손상24 h、72 h분별주초성심동도평개좌심실수축、서장공능,병여대조조비교,동시채용방사면역분석법검측각조혈장NPY수평. 결과 급성로뇌손상후24 h급72 h좌실사혈분수(EF)、매박수출량(SV)、주동맥판구봉류속(AV)、매분종심수출량(CO)、심장지수(CI)등각심공능삼수중도조여경도조、대조조차이균유통계학의의(균P＜0.05),경도조여대조조상술지표균무통계학의의(균P＞0.05);혈장NPY수평재경도조여중도조간、대조조여중도조간차이균유통계학의의(균P＜0.05).경직선상관분석,혈장NPY수평승고여심공능삼수변화정부상관계(EF:r=-0.79,SV:r=-0.71,AV:r=-0.67,E/A:r=-0.63,균P＜0.01;CO:r=-0.32、CI:r=-0.35,균P＜0.05). 결론 급성중도로뇌손상환자심장공능하강명현,차여NPY수평상관.
Objective To observe the cardiac function in acute brain injury patients(ABI)and the relationship between ABI and plasma neuropeptideY(NPY),and to inspect the mechanism and find the evidences for preventing cardiac impairment caused by ABI. Methods 89 patients with acute brain injury within 24 hours after the injury were divided into severe group(n =47)and mild group(n = 42)according to Glasgow Coma Scale(GCS),and 35 normal healthy adults were selected as control group.In 24 hours and 72 hours after the brain injury,all patients were examined with echocardiography to observe cardiac structure,Doppler blood flow velocity and cardiac function,and in the same time the plasma NPY were determined by radioimmunoassay.Then the results were compared with controls. Results The parameters of cardiac function such as EF、 SV.AV、CO、CI had statistical change in 24 hours and 72hours after the brain injury between severe ABI group and mild ABI group,and it also had statistical change between severe ABI group and control group(all P <0.05),but no statistical change between mild ABI group and control group(all P ＜0.05).The level of plasma NPY in ABI patients was significantly higher than that before injury,there was statistically different change between severe ABI group and mild ABI group,and it also had statistical change between severe ABI group and control group(all P＜0.05).The parameters of cardiac function was negatively correlated with the rise of plasma NPY by pearson correlation analysis(EF:r =- 0.79,P <0.01; SV:r =- 0.71,P <0.01;AV:r=-0.67,P ＜0.01 ;E/A:r =-0.63,all P ＜0.01)and(CO:r =- 0.32,P ＜0.05;CI:r =-0.35,all P ＜0.05). Conclusion The parameters of cardiac function were significantly decreased in the patients with acute brain injury,and it was closely related with the level of plasma NPY.