CAJ | 학술논문

目的探讨血管内皮细胞钙黏蛋白(VE-cadherin)在进展性脑梗死发病过程中的变化及临床意义.方法病例组:急性脑梗死患者167例,为2006年5月至2007年7月期间在山东省荣军总医院和滕州市中心人民医院的住院患者,符合1995年全国第四届脑血管病会议修订的诊断标准.其中进展性脑梗死102例,按Pullicino公式计算,分为大梗死灶组(32例),中梗死灶组(34例)和小梗死灶组(36例).病情程度按1995全国第四届脑血管病会议通过的脑卒中患者临床神经功能缺损程度评分标准分为3组:轻型组38例,中型组32例,重型组32例.稳定性脑梗死组65例,病情稳定,无头痛、头晕及耳鸣等不适.对照组:共印名,来自健康体检者,排除各种急慢性疾病.所有急性脑梗死患者在人院当时采集肘静脉血(发病6 h内),以后分别在24 h、3 d、7 d、14 d、21 d分别采集清晨空腹静脉血,对照组采等量空腹静脉血,分离血清进行检测.VE-cadherin采用酶联免疫.双抗体夹心法测定.计量资料以均数±标准差(x±s)表示.应用SPSS 10.0软件统计处理,多组间均数比较采用One-wayANOVA.结果进展性脑梗死患者血清VE-cadherin急性期升高,发病3d达高峰,以后逐渐下降,7 d下降明显,21 d接近正常对照,与稳定性脑梗死组和对照组相比,有非常显著意义(P<0.01).梗死体积大则血清VE-cadherin浓度高;重型组血清VE-cadherin浓度高于轻型组.结论血清VE-cadherin浓度与梗死大小、病程、病情严重程度相关,进展性脑梗死患者血清VE-cadherin高于稳定性脑梗死组和对照组.VE-cadherin可作为脑梗死的预警因子,对缺血性脑血管病的防治具有重要的临床应用价值.
목적 탐토혈관내피세포개점단백(VE-cadherin)재진전성뇌경사발병과정중적변화급림상의의.방법 병례조:급성뇌경사환자167례,위2006년5월지2007년7월기간재산동성영군총의원화등주시중심인민의원적주원환자,부합1995년전국제사계뇌혈관병회의수정적진단표준.기중진전성뇌경사102례,안Pullicino공식계산,분위대경사조조(32례),중경사조조(34례)화소경사조조(36례).병정정도안1995전국제사계뇌혈관병회의통과적뇌졸중환자림상신경공능결손정도평분표준분위3조:경형조38례,중형조32례,중형조32례.은정성뇌경사조65례,병정은정,무두통、두훈급이명등불괄.대조조:공인명,래자건강체검자,배제각충급만성질병.소유급성뇌경사환자재인원당시채집주정맥혈(발병6 h내),이후분별재24 h、3 d、7 d、14 d、21 d분별채집청신공복정맥혈,대조조채등량공복정맥혈,분리혈청진행검측.VE-cadherin채용매련면역.쌍항체협심법측정.계량자료이균수±표준차(x±s)표시.응용SPSS 10.0연건통계처리,다조간균수비교채용One-wayANOVA.결과 진전성뇌경사환자혈청VE-cadherin급성기승고,발병3d체고봉,이후축점하강,7 d하강명현,21 d접근정상대조,여은정성뇌경사조화대조조상비,유비상현저의의(P<0.01).경사체적대칙혈청VE-cadherin농도고;중형조혈청VE-cadherin농도고우경형조.결론 혈청VE-cadherin농도여경사대소、병정、병정엄중정도상관,진전성뇌경사환자혈청VE-cadherin고우은정성뇌경사조화대조조.VE-cadherin가작위뇌경사적예경인자,대결혈성뇌혈관병적방치구유중요적림상응용개치.
Objective To investigate the changes and clinical implications of VE-eadherin during the courseof progressive cerebral infarction.Method One hundred sixty-seven patients with acute cerebral infarction of Rong Jun General Hospital of Shandong Province and the Central People' s Hospital of Tengzhou were diagnosed in our hospital from May 2006 to July 2007,were diagnosed according to the ill%gnome criteria set by the 4th national cerebrovascular disease conference in 1995.Of them there were 102 ases with progressive cerebral infarction patients and 65 cases with non-progressive cerebral infaction.The progressive cerebral infarction patients were divided into 3 groups according to Pullicino's expressions:the big infarction focus(32 patients) ,the medium-sized infarction focus(34 patients) and the small infarction focus(36 patients) .The neurological deficits were divided into 3 groups according to the crrteria set by the 4th national cerebrovascular disease conference in 1995:light-defictits(38 patients),the moderate dificits (32 patients) and sever ditlcits (32 patients).The 65 non-progressive irffarction patients were stable without headache,vertigo and tinnitus.Arother 60 healthy subjects were entered as control group.Blood samples of all the patients' were collected at 0 h,24 h,3 d,7 d,14 d,24 d and the serum VE-eadherin by ELISA method was asaayed.All the data were analyzed by SPSS 10.0 software and One-way ANOVA was applied to intergroup comparisons for mote than two groups.Results The VF-cadherin level of patieras with progressive infarction increased in acute stage,reached the peak 3 days after onset,declined remarkably 7 days later and got nearly normalized within 21 days.The results were significantly different from those of non-progressive and controlgroup(P＜0.01).The VE-cadherin concentration was higher in patients with bigger size infarction and more sever symptoms.Conclusions The VE-cadherin level is related to the infarction size,course and the severity,and higher in the progressive group.VE-cadherin could be used for predicting prognostic of cerebral infarction and clinically valuable for treating ischemie cerebrovascular disease.