CAJ | 학술논문

目的：通过病例对照的方式研究缺血性卒中急性期血浆神经递质水平与正常人群之间的差异，同时研究不同严重程度卒中患者的血浆递质水平的差异。方法选取连续入组、发病在14d内的急性缺血性卒中患者，采集急性期的血样标本，通过液相色谱-高分辨质谱外标法测量比较卒中组以及正常对照组血浆内的5-羟色胺、去甲肾上腺素、谷氨酸和γ-氨基丁酸4种神经递质的浓度。同时比较不同卒中严重程度患者的4种神经递质浓度。结果共268例缺血性卒中患者入组，其急性期血浆神经递质与正常对照组相比，血浆5-羟色胺（t=2.289，P=0.023）、去甲肾上腺素（t=0.0903，P=0.367）和谷氨酸有上升趋势（t=0.277， P=0.782），γ-氨基丁酸有下降趋势（t=-4.4145，P=0.000），其中5-羟色胺和γ-氨基丁酸在两组之间的差异有显著性。中重度卒中患者血浆5-羟色胺水平显著高于轻度卒中患者（t=2.197， P=0.029）。结论缺血性卒中急性期血浆神经递质水平与正常对照相比有差异，中重度卒中患者的血浆5-羟色胺水平升高较轻度卒中患者显著。
목적：통과병례대조적방식연구결혈성졸중급성기혈장신경체질수평여정상인군지간적차이，동시연구불동엄중정도졸중환자적혈장체질수평적차이。방법선취련속입조、발병재14d내적급성결혈성졸중환자，채집급성기적혈양표본，통과액상색보-고분변질보외표법측량비교졸중조이급정상대조조혈장내적5-간색알、거갑신상선소、곡안산화γ-안기정산4충신경체질적농도。동시비교불동졸중엄중정도환자적4충신경체질농도。결과공268례결혈성졸중환자입조，기급성기혈장신경체질여정상대조조상비，혈장5-간색알（t=2.289，P=0.023）、거갑신상선소（t=0.0903，P=0.367）화곡안산유상승추세（t=0.277， P=0.782），γ-안기정산유하강추세（t=-4.4145，P=0.000），기중5-간색알화γ-안기정산재량조지간적차이유현저성。중중도졸중환자혈장5-간색알수평현저고우경도졸중환자（t=2.197， P=0.029）。결론결혈성졸중급성기혈장신경체질수평여정상대조상비유차이，중중도졸중환자적혈장5-간색알수평승고교경도졸중환자현저。
Objective To explore the differences in plasma neurotransmitter levels between acute ischemic stroke patients and normal controls, and to investigate the role of neurotransmitters in the stroke severity. Methods Consecutively recruited and less than 14 d acute ischemic stroke patients were selected. Blood samples were harvested from these subjects at the acute stage of stroke. The plasma levels of four neurotransmitters (i.e. 5-hydroxytryptamine, norepinephrine, glutamate, andγ-aminobutyric acid) were determined by using liquid chromatography-high-resolution mass spectrometry in the patients and normal controls. The neurotransmitter levels were also compared between the different stroke severity groups. Results A total of 268 patients enrolled in our study. Compared with the normal controls, the patients with acute ischemic stroke had signiifcantly higher level of 5-hydroxytryptamine (t=2.289, P=0.023) and lower level ofγ-aminobutyric acid (t=-4.4145, P=0.000);however, there were no significant differences in the levels of norepinephrine (t=0.0903, P=0.367) and glutamate (t=0.277, P=0.782) between these two groups. Compared with the mild stroke severity patients, the patients with moderate or severe stroke had a signiifcantly higher level of 5-hydroxytryptamine (t=2.197, P=0.029). Conclusion The plasma neurotransmitter levels differ between acute ischemic stroke patients and normal controls. Increased concentration of 5-hydroxytryptamine is correlated with stroke severity.