CAJ | 학술논문

目的：观察血清D－二聚体、胰岛素样生长因子（ IGF－1）及其结合蛋白－3（IGFBP－3）和淀粉样蛋白A（SAA）在急性脑梗死检测中的意义。方法选择急性脑梗死患者87例作为急性脑梗死组，根据患者神经功能损害程度评分分为轻度组32例、中度组18例和重度组37例，根据CT显示病灶最大直径大小分为小面积组29例、中面积组22例和大面积组36例。选择同期行健康体检者30例作为健康对照组。比较急性脑梗死组和健康对照组血清D－二聚体、IGF－1、IGFBP－3和SAA水平，分析急性脑梗死组上述各指标水平与神经功能缺损评分和脑梗死面积的关系，观察急性脑梗死患者治疗前后上述各指标水平的变化。结果急性脑梗死组的血清D－二聚体和SAA水平均明显高于健康对照组（ P均＜0．05），且随着神经损伤程度和脑梗死面积增加而明显升高（P均＜0．05）；治疗后急性脑梗死组患者血清D－二聚体和SAA水平均较治疗前明显降低（P均＜0．05）。急性脑梗死组血清IGF－1和IGFBP－3水平均明显低于健康对照组（P均＜0．05），并随着神经损伤程度和脑梗死面积的增加而明显降低（P均＜0．05）；治疗后急性脑梗死组患者IGF－1和IGFBP－3水平较治疗前明显升高（P均＜0．05）。结论 D－二聚体、IGF－1、IGFBP－3和SAA参与了急性脑梗死的发生发展，对于判断脑梗死的病情严重程度、脑梗死面积的大小和预后具有重要意义。
목적：관찰혈청D－이취체、이도소양생장인자（ IGF－1）급기결합단백－3（IGFBP－3）화정분양단백A（SAA）재급성뇌경사검측중적의의。방법선택급성뇌경사환자87례작위급성뇌경사조，근거환자신경공능손해정도평분분위경도조32례、중도조18례화중도조37례，근거CT현시병조최대직경대소분위소면적조29례、중면적조22례화대면적조36례。선택동기행건강체검자30례작위건강대조조。비교급성뇌경사조화건강대조조혈청D－이취체、IGF－1、IGFBP－3화SAA수평，분석급성뇌경사조상술각지표수평여신경공능결손평분화뇌경사면적적관계，관찰급성뇌경사환자치료전후상술각지표수평적변화。결과급성뇌경사조적혈청D－이취체화SAA수평균명현고우건강대조조（ P균＜0．05），차수착신경손상정도화뇌경사면적증가이명현승고（P균＜0．05）；치료후급성뇌경사조환자혈청D－이취체화SAA수평균교치료전명현강저（P균＜0．05）。급성뇌경사조혈청IGF－1화IGFBP－3수평균명현저우건강대조조（P균＜0．05），병수착신경손상정도화뇌경사면적적증가이명현강저（P균＜0．05）；치료후급성뇌경사조환자IGF－1화IGFBP－3수평교치료전명현승고（P균＜0．05）。결론 D－이취체、IGF－1、IGFBP－3화SAA삼여료급성뇌경사적발생발전，대우판단뇌경사적병정엄중정도、뇌경사면적적대소화예후구유중요의의。
Objective It is to observe the significance of serum amyloid A ( SAA ) , insulin-like growth factor ( IGF-1), insulin-like growth factor binding protein -3 (IGFBP-3) and D-dimer in patients with acute cerebral infarction de -tection.Methods 87 patients with acute cerebral infarction selected as acute cerebral infarction were divided into mild group (32 cases), moderate group (18 cases) and severe group (37 cases ) according to neurological impairment score , and were also divided into small area group (29 cases), middle area group (22 cases) and large area group (36 cases) according to the maximum diameter by CT.30 healthy persons were selected as control group .The levels of D-dimer, IGF-1, IGFBP-3 and SAA were compared between acute cerebral infarction group and healthy control group , the relationship among the levels of D-dimer, IGF-1, IGFBP-3 and SAA IGF-1, neurological deficit scores and infarct area were observed in acute cerebral infarction, D-dimer, IGF-1, IGFBP-3 and SAA levels were also detected before and after treatment in patients with acute cerebral infarction .Results The levels of D-dimer and SAA in acute cerebral infarction group was significantly higher than those in control group ( P<0.01 ) , the D-dimer and SAA levels increased in acute cerebral infarction group , as the neuro-logical deficit scores and infarct area increased (P<0.01), and after treatment D -dimer and SAA levels were significantly lower than those before treatment ( P<0 .01 );while the levels of IGF-1 and IGFBP-3 were significantly lower in acute cer-ebral infarction group compared with control group (P<0.01), and the levels of IGF -1 and IGFBP-3 were significantly lower in acute cerebral infarction area as the neurological deficit scores and infarct area increased (P<0.01), after treatment the levels of IGF-1 and IGFBP-3 levels significantly increased than those before treatment (P<0.01).Conclusion The levels of D-dimer, IGF-1,IGFBP-3 and SAA involve in the development of acute cerebral infarction , it is of great signifi-cance for judging the severity of cerebral infarction and infarct size .