急性脑梗死患者血清S100B蛋白水平的变化及其临床意义分析

发布时间：2018-06-02 04:27

本文选题：急性脑梗死 + 脑损伤　；参考：《郑州大学》2013年硕士论文

【摘要】：背景和目的 S100B蛋白是一种小分子酸性钙结合蛋白,主要存在于神经胶质细胞、星形胶质细胞和Schwann细胞。它在S100蛋白一大家族中占绝大部分,活性也最高,在中枢神经系统损伤中高度特异,是神经胶质细胞活化和(或)损伤的重要标志之一。本研究通过探讨急性脑梗死患者血清S100B蛋白水平的变化,以及血清S100B蛋白水平在急性脑梗死患者中不同梗死面积及不同梗死部位的变化及其与神经功能缺损程度的关系,分析和评价血清S100B蛋白在急性脑梗死患者中的水平变化及其临床意义。对象和方法 1.研究对象和分组：收集2012年2月-2013年1月在郑州大学第二附属医院神经内科就诊的86例急性脑梗死(发病后48h内入院)患者的临床资料,将其作为病例组,诊断符合《中国急性缺血性脑卒中诊治指南2010))的诊断标准,并经核磁共振成像(MRI)或者计算机断层扫描(CT)检查明确诊断。将同期在郑州大学第二附属医院体检的68例健康体检者作为对照组。根据病例组的梗死面积再分为小面积梗死组、中等面积梗死组及大面积梗死组。最后根据病例组的梗死部位分为皮质梗死组(包括额叶、顶叶、颞叶、枕叶)、皮质下梗死组(包括脑干、基底节区、丘脑、内囊等)、皮质和皮质下梗死组(皮质和皮质下同时梗死)、小脑梗死组。 2.研究方法：病例组记录其性别、年龄、梗死面积、梗死部位,病例组患者发病后48±2h抽血送检S100B蛋白,同时由神经内科专业医师进行全面神经系统检查,并即刻行NIHSS评分。对照组记录其性别、年龄,并检测血清S100B蛋白含量。 3.统计处理：应用SPSS17.0软件进行统计学分析。对计量资料用均数±标准差(x±s)表示。两组计量资料比较用t检验,多组间数据比较用单因素方差分析,S100B蛋白与NIHSS评分的相关性比较采用Pearson相关分析,P0.05时认为有统计学意义。结果 1.病例组与对照组比较,年龄、性别差异无统计学意义(P0.05)。86例急性脑梗死患者中,小面积梗死组44例,占51.2%,中等面积梗死组32例,占37.2%,大面积梗死组10例,占11.6%。皮质梗死组12例,占14%,皮质下梗死组42例,占48.8%,小脑梗死组14例,占16.3%,皮质和皮质下梗死组18例,占20.9%。 2.病例组血清S100B蛋白含量(172.42±49.88ng/L)明显高于对照组(38.86±12.90ng/L),两组间血清S100B蛋白含量比较具有统计学意义(P0.05)。 3.病例组中小面积梗死组、中等面积梗死组和大面积梗死组的S100B蛋白含量组间比较,差异有显著性(P0.05),随着梗死面积的增大,S100B蛋白含量明显升高；各组间NIHSS评分也具有显著差异(P0.05),也随着梗死面积的增大而增高。 4.急性脑梗死患者中,皮质、皮质下梗死组的S100B蛋白含量显著高于其余三组(P0.05),皮质梗死组的S100B蛋白含量与皮质下梗死组和小脑梗死组组间比较差异无统计学意义(P0.05)。四组间NIHSS评分比较,皮质、皮质下梗死组的NIHSS评分显著高于其余三组(P0.05),皮质梗死组与皮质下梗死组和小脑梗死组组间比较差异无统计学意义(P0.05)。 5.病例组中血清S100B蛋白含量与NIHSS评分的相关性,经Pearson相关性分析,相关系数r=0.653,P0.05,即血清S100B蛋白水平与入院时NIHSS评分呈正相关。结论 1.急性脑梗死患者血清S100B蛋白水平明显升高,且与脑梗死后脑损伤的严重程度相关。 2.随着梗死面积的增大,血清S100B蛋白含量也相应升高,相对应的神经功能缺损评分也增大。 3.血清S100B蛋白含量与脑梗死的梗死部位无关。 4.血清S100B蛋白含量与NIHSS评分呈正相关。
[Abstract]:Background and purpose
S100B protein is a small molecule acidic calcium binding protein, which mainly exists in glial cells, astrocytes and Schwann cells. It is most important in the large family of S100 protein and is highly active. It is highly specific in the central nervous system damage and is one of the important markers of glial cell activation and / or damage.
In this study, the changes of serum S100B protein level in patients with acute cerebral infarction and the relationship between the changes of different infarct areas and different Infarct Sites in patients with acute cerebral infarction and the relationship between the level of S100B protein in acute cerebral infarction and the degree of neural function defect were analyzed and evaluated, and the level changes of serum S100B egg white in patients with acute cerebral infarction were analyzed and evaluated. Its clinical significance.
Objects and methods
1. subjects and groups: to collect the clinical data of 86 patients with acute cerebral infarction (hospitalized after 48h) in the neurology department of the Second Affiliated Hospital of Zhengzhou University, February 2012 -2013, as a case group, and the diagnostic criteria for the diagnosis of acute ischemic stroke in China (2010)) and nuclear magnetic resonance imaging (M RI) or computer tomography (CT) examination. 68 healthy persons who were examined in the Second Affiliated Hospital of Zhengzhou University in the same period were taken as control group.
The infarct area was divided into small area infarction group, medium area infarct group and large area infarction group. Finally, the infarction group was divided into cortical infarction group (frontal lobe, parietal lobe, temporal lobe, occipital lobe) and subcortical infarction group (including brain stem, basal ganglia, thalamus, internal capsule, etc.), cortical and subcortical infarction group (cortex and skin). Inferior concomitant infarct), cerebellar infarction.
2. study method: the case group recorded the sex, age, infarct area, the location of the infarct, and the S100B protein of the case group after the onset of the disease. At the same time, the total nerve system examination was performed by the specialist in the neurology department, and the NIHSS score was immediately followed. The sex, age, and the serum S100B protein content were recorded in the control group.
3. statistical processing: statistical analysis was carried out with SPSS17.0 software. The mean number + standard deviation (x + s) was used for measurement data. Two groups of measurement data were compared with t test. The data of multiple groups were compared with single factor analysis of variance. The correlation of S100B protein and NIHSS score was compared with Pearson phase analysis, and P0.05 thought there was statistical significance.
Result
1. case group and control group, age, sex difference was not statistically significant (P0.05).86 cases of acute cerebral infarction, small area infarction group 44 cases, 51.2%, medium area infarction group 32 cases, 37.2%, large area infarction group 10 cases, accounting for 12 cases in 11.6%. cortical infarction group, 14%, 48.8% subcortical infarction group, 48.8% cerebellar infarction group, 16.3%, accounting for 16.3%, 18 cases of cortical and subcortical infarcts, accounting for 20.9%.
The content of serum S100B protein (172.42 + 49.88ng/L) in 2. cases group was significantly higher than that of the control group (38.86 + 12.90ng/L), and the serum S100B protein content of the two groups was statistically significant (P0.05).
3. small area infarct group, middle area infarct group and large area infarction group in 3. case group were significantly different (P0.05). With the increase of infarct size, the content of S100B protein increased significantly, and the NIHSS scores in each group were also significantly different (P0.05), and increased with the increase of infarct size.
4. of the patients with acute cerebral infarction, the content of S100B protein in the cortical and subcortical infarcts was significantly higher than that in the other three groups (P0.05). There was no significant difference between the S100B protein content in the cortical infarction group and the subcortical infarct group and the cerebellar infarction group (P0.05). The NIHSS scores in the cortex and subcortical infarcts were significantly higher in the four groups. In the other three groups (P0.05), there was no significant difference between the cortical infarction group and the subcortical infarction group and cerebellar infarction group (P0.05).
The correlation between the serum S100B protein content and the NIHSS score in 5. cases group was analyzed by Pearson correlation. The correlation coefficient r=0.653, P0.05, that is, the serum S100B protein level was positively correlated with the admission NIHSS score.
conclusion
1. the level of serum S100B protein in patients with acute cerebral infarction increased significantly, and was related to the severity of brain injury after cerebral infarction.
2. with the increase of infarct size, the serum S100B protein content increased correspondingly, and the corresponding neurological deficit score increased.
3. the level of serum S100B protein was not related to infarction site of cerebral infarction.
4. serum S100B protein content was positively correlated with NIHSS score.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R743.33

【参考文献】