盐酸小檗碱与阿托伐他汀钙对急性脑梗死患者外周血嗜碱性粒细胞比例及计数的影响

发布时间：2018-04-15 06:19

  本文选题：急性脑梗死 + 盐酸小檗碱　； 参考：《大连医科大学》2013年硕士论文

【摘要】：目的：观察急性脑梗死患者外周血嗜碱性粒细胞比例（BASO%），嗜碱性粒细胞计数（BASO计数）的动态变化，比较盐酸小檗碱与阿托伐他汀钙对前述指标的影响，探讨BASO%、BASO计数与神经功能缺损程度及血清诱导型一氧化氮合酶（iNOS）水平的关系，并进一步探讨盐酸小檗碱与阿托伐他汀钙对急性脑梗死的作用及其可能的病理生理机制。 方法：选择健康体检者75例为对照组，发病48小时内的急性脑梗死患者119例为脑梗死组，均符合入组标准和排除标准，两组在年龄、性别构成、伴发糖尿病情况方面具有可比性。采用对照研究的方法，根据治疗方案的不同，将脑梗死组随机分为常规组（51例）、小檗碱组（32例）和他汀组（36例），三组在年龄、性别构成及病情严重程度方面具有可比性。用日本sysmex XE型全自动血细胞分析仪及配套试剂检测外周血BASO%、BASO计数（×109/L），采用化学比色法测定血清iNOS水平（U/ml），观察发病48小时内（治疗前）及入院后第10天（治疗后）外周血BASO%、BASO计数变化。对脑梗死组患者的神经功能缺失程度采用美国国立卫生研究院卒中量表（NIHSS）进行评定，分别于治疗前后各评定一次。第一次（治疗前）结果记为“1”，第二次（治疗后）结果记为“2”.所有数据采用SPSS20.0统计软件进行处理，检验显著性水准为双侧检验P0.05。 结果： 1、脑梗死组外周血BASO%1（0.200±0.288）、BASO%2（0.300±0.300）、BASO计数1（0.012±0.022）与对照组（0.281±0.206，0.017±0.013）比较无显著差异，，BASO计数2（0.020±0.021）与对照组比较显著升高（P0.05）。 2、脑梗死组外周血BASO%1、BASO%2、BASO计数1、BASO计数2与两次NIHSS评分（4.070±2.462,2.580±2.338）呈正相关趋势（相关系数为正），但相关不显著。 脑梗死组外周血BASO%1、两次BASO计数与iNOS1（18.007±5.889）、iNOS2（14.411±7.556）呈正相关趋势（相关系数为正），但相关不显著，BASO%2与iNOS1、iNOS2呈显著正相关（r=0.300、0.251，均为P0.05）。 3、常规组、小檗碱组及他汀组治疗前外周血BASO%1（0.200±0.250，0.268±0.254，0.252±0.258）、BASO计数1（0.011±0.017，0.018±0.018，0.015±0.015）及NIHSS1（4.160±2.493，4.340±3.012，3.690±1.818）无显著差异。 常规组外周血BASO%2（0.300±0.350）、BASO计数2（0.020±0.026）较BASO%1、BASO计数1明显升高（P0.01），他汀组外周血BASO%2（0.393±0.220）、BASO计数2（0.025±0.013）较BASO%1、BASO计数1明显升高（P0.01），小檗碱组外周血BASO%2（0.285±0.315）、BASO计数2（0.019±0.021）较BASO%1、BASO计数1升高不明显。 常规组、他汀组、小檗碱组NIHSS2（3.000±2.698，2.030±2.197，2.530±1.722）较NIHSS1明显降低，差异有统计学意义（均为P0.01）。 结论： 1.急性脑梗死患者外周血BASO计数显著升高，提示BASO可能参与了急性脑梗死的病理生理过程。 2.急性脑梗死患者外周血BASO%与血清iNOS水平呈显著正相关，提示两者在急性脑梗死的病理生理过程中可能有密切的联系。 3.盐酸小檗碱可以抑制急性脑梗死患者外周血BASO%、BASO计数的升高，阿托伐他汀钙则无此作用，确切的临床意义有待于进一步深入研究。
[Abstract]:Objective : To observe the dynamic changes of basophilic granulocyte count ( BASO % ) and basophilic granulocyte count ( BASO ) in peripheral blood of patients with acute cerebral infarction . The relationship between BASO % , BASO count and the level of neurological deficit and serum inducible nitric oxide synthase ( iNOS ) were investigated . The effects of berberine hydrochloride and atorvastatin calcium on acute cerebral infarction were discussed .

Methods : Seventy - five patients with cerebral infarction were randomly divided into routine group ( 51 cases ) , berberine group ( 32 cases ) and statin group ( 36 cases ) . The patients with cerebral infarction were randomly divided into routine group ( 51 cases ) , berberine group ( 32 cases ) and statin group ( 36 cases ) .

Results :

1 . There was no significant difference between BASO % 1 ( 0.200 卤 0.288 ) , BASO % 2 ( 0.300 卤 0.300 ) , BASO count ( 0 . 012 卤 0 . 022 ) and control group ( 0 . 281 卤 0 . 206 , 0 . 017 卤 0 . 013 ) . BASO count 2 ( 0.020 卤 0.021 ) was significantly higher than that of control group ( P0.05 ) .

2 . BASO % 1 , BASO % 2 , BASO count 1 , BASO count 2 and NIHSS score ( 4.070 卤 2.462 , 2.580 卤 2.338 ) showed positive correlation trend ( positive correlation coefficient ) , but the correlation was not significant .

There was positive correlation between BASO count and iNOS1 ( 18.007 卤 5.889 ) and iNOS2 ( 14.411 卤 7.556 ) in peripheral blood of cerebral infarction group , but the correlation was not significant . BASO % 2 was positively correlated with iNOS1 and iNOS2 ( r = 0.300 , 0.251 , all P0.05 ) .

3 . There was no significant difference in BASO % 1 ( 0.200 卤 0.250 , 0.268 卤 0.254 , 0.252 卤 0.258 ) , BASO count 1 ( 0 . 011 卤 0 . 017 , 0 . 018 卤 0 . 018 , 0.015 卤 0.015 ) and NIH 1 ( 4 . 160 卤 2 . 493 , 4 . 340 卤 3 . 012 , 3 . 690 卤 1 . 818 ) .

BASO % 2 ( 0.393 卤 0.220 ) , BASO count 2 ( 0.025 卤 0 . 013 ) , BASO % 2 ( 0 . 285 卤 0 . 315 ) , BASO count 2 ( 0.019 卤 0.021 ) and BASO % 1 , BASO count 1 were significantly higher than that of BASO % 1 and BASO % 1 , BASO % 2 ( 0 . 285 卤 0 . 315 ) , BASO count 2 ( 0.019 卤 0.021 ) , BASO % 1 , BASO count 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BASO % 1 , BAS@@

Compared with the conventional group , the NIH2 2 ( 3.000 卤 2.698 , 2.030 卤 2.197 , 2.530 卤 1.722 ) decreased significantly in the conventional group , the berberine group , the berberine group ( 3.000 卤 2.698 , 2.030 卤 2.197 , 2.530 卤 1.722 ) , and the difference was statistically significant ( P0.01 ) .

Conclusion :

1 . The increase of BASO count in peripheral blood of patients with acute cerebral infarction suggested that BASO might be involved in the pathological process of acute cerebral infarction .

2 . There was a positive correlation between BASO % and the level of iNOS in peripheral blood of patients with acute cerebral infarction , suggesting that there might be a close relationship between them in the pathogenesis of acute cerebral infarction .

3 . berberine hydrochloride can inhibit the increase of BASO and BASO in peripheral blood of patients with acute cerebral infarction .

【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R743.33

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