盐酸小檗碱与阿托伐他汀钙对急性脑梗死患者外周血单核细胞比例及计数的影响
发布时间：2018-09-14 18:51
【摘要】：目的：观察急性脑梗死患者外周血单核细胞比例（MONO%）及单核细胞（MONO）计数的动态变化，及其与血清C反应蛋白（CRP）水平、神经功能缺损程度的关系，探讨MONO在急性脑梗死中的作用及其可能的病理生理机制。并进一步研究盐酸小檗碱及阿托伐他汀钙对急性脑梗死患者MONO%及MONO计数的影响，探讨盐酸小檗碱及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，均符合入组标准及排除标准，两组在年龄、性别构成方面具有可比性。采用对照研究的方法，将脑梗死组随机分为常规组（51例），，小檗碱组（32例），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。采用日本SysmexXE型全自动血细胞分析仪及配套试剂检测外周血MONO%及MONO计数（×109/L），用速率散射比浊法检测血清CRP水平（mg/L），观察脑梗死组发病48小时内（治疗前）及入院后第10天（治疗后）外周血MONO%及MONO计数的变化。并于治疗前后应用美国国立卫生研究院的卒中量表（NIHSS）对脑梗死组患者的神经功能缺损程度进行评定。第一次结果记为“1”，第二次结果记为“2”，第一次结果减第二次结果的差值记“差”。所有数据采用SPSS20.0统计软件进行处理，检验的显著性水准为双侧检验P0.05。 结果： 1．脑梗死组外周血MONO%1（6.30±2.44）与对照组（6.61±2.76）比较略有降低，MONO计数1（0.44±0.18）与对照组（0.40±0.18）比较略有增高，差异均不显著。脑梗死组外周血MONO%2（7.53±2.21）、MONO计数2（0.50±0.20）与对照组比较显著增高（P0.05，P0.01）。脑梗死组外周血MONO%2、MONO计数2较MONO%1、MONO计数1明显升高（P0.01，P0.01）。 2．脑梗死组外周血MONO%1、MONO计数1与两次NIHSS评分（4.07±2.46，2.58±2.34）及NIHSS差（1.49±2.00）无显著相关；MONO%2与NIHSS2无显著相关，MONO计数2与NIHSS2呈显著正相关（r=0.238，P0.05）；MONO%差、MONO计数差与两次NIHSS评分及NIHSS差无显著相关。 3．脑梗死组两次外周血MONO%与两次血清CRP水平（2.47±3.40，3.47±5.27）无显著相关；MONO%差与CRP2呈显著负相关（r=-0.233，P0.05）、与CRP差（-0.96±6.08）呈显著正相关（r=0.257，P0.05），而与CRP1无显著相关。脑梗死组外周血MONO计数1与CRP1呈显著正相关（r=0.285，P0.01），而与CRP2、CRP差无显著相关；MONO计数2与CRP2呈显著正相关（r=0.228，P0.05），而与CRP1、CRP差无显著相关；MONO计数差与CRP差呈显著正相关（r=0.245，P0.05），而与CRP1、CRP2无显著相关。 4．常规组、小檗碱组及他汀组治疗前外周血MONO%（6.52±2.28，6.06±2.07，6.57±2.80）、MONO计数（0.47±0.19，0.43±0.13，0.43±0.20）及NIHSS评分（4.16±2.50，4.34±3.01，3.69±1.82）无显著差异。 常规组外周血MONO%、MONO计数治疗后（8.13±2.33，0.52±0.18）较治疗前升高明显（P0.01，P0.05），他汀组外周血MONO%、MONO计数治疗后（7.52±1.82，0.50±0.20）较治疗前升高明显（P0.05，P0.05），小檗碱组外周血MONO%、MONO计数治疗后（6.73±2.15，0.47±0.24）较治疗前升高不明显。 常规组、小檗碱组、他汀组治疗后NIHSS评分（3.00±2.70，2.53±1.72，2.03±2.20）较治疗前比显著降低，差异有统计学意义（P0.01，P0.01，P0.01）。 结论： 1．急性脑梗死患者外周血MONO%、MONO计数显著升高，提示MONO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MONO计数可以反映脑梗死病情的严重程度，MONO计数高者神经功能缺损程度较重。 3．急性脑梗死患者外周血MONO计数可以反映脑梗死的炎症反应程度，外周血MONO计数高者脑梗死的炎症反应程度较重，提示MONO可能与急性脑梗死的炎症反应过程关系密切。 4．盐酸小檗碱可以抑制急性脑梗死患者外周血MONO%、MONO计数的升高，阿托伐他汀钙则无此作用，提示急性脑梗死患者应用盐酸小檗碱比应用阿托伐他汀钙治疗可能获益更多。
[Abstract]:AIM: To observe the dynamic changes of peripheral blood mononuclear cell ratio (MONO%) and mononuclear cell (MONO) count in patients with acute cerebral infarction and their relationship with serum C-reactive protein (CRP) level and neurological impairment, and to explore the role of MONO in acute cerebral infarction and its possible pathophysiological mechanism. To investigate the effect of atorvastatin calcium on MONO% and MONO count in patients with acute cerebral infarction and the possible pathophysiological mechanism of berberine hydrochloride and atorvastatin calcium on acute cerebral infarction.
Methods: 75 healthy subjects were selected as control group, 119 patients with acute cerebral infarction within 48 hours after onset were selected as cerebral infarction group, which met the criteria of inclusion and exclusion. The age and sex composition of the two groups were comparable. The cerebral infarction group was randomly divided into routine group (51 cases), berberine group (32 cases) and statin group. The three groups were comparable in age, sex composition and severity of the disease. The MONO% and MONO count in peripheral blood were measured by Japanese Sysmex XE automatic blood cell analyzer and matching reagents ( Changes of MONO% and MONO count in peripheral blood on the 10th day after treatment were assessed with the National Institutes of Health Stroke Scale (NIHSS). All data were processed by SPSS20.0 statistical software. The significant level of the test was bilateral test P0.05..
Result:
1. The MONO% 1 (6.30+2.44) in peripheral blood of cerebral infarction group was slightly lower than that of control group (6.61+2.76), and the MONO count 1 (0.44+0.18) was slightly higher than that of control group (0.40+0.18). The MONO% 2 (7.53+2.21) and MONO 2 (0.50+0.20) in peripheral blood of cerebral infarction group were significantly higher than that of control group (P 0.05, P 0.01). MONO%2, MONO count 2 was significantly higher than MONO%1 and MONO count 1 (P0.01, P0.01).
2. There was no significant correlation between MONO% 1, MONO count 1 and two NIHSS scores (4.07+2.46, 2.58+2.34) and NIHSS difference (1.49+2.00) in cerebral infarction group; MONO% 2 was not significantly correlated with NIHSS2, MONO count 2 was positively correlated with NIHSS2 (r = 0.238, P 0.05); MONO% difference, MONO count was not significantly correlated with two NIHSS scores and NIHSS difference.
3. There was no significant correlation between MONO% in peripheral blood and serum CRP level (2.47 65 MONO count 2 was positively correlated with CRP 2 (r = 0.228, P 0.05), but not with CRP 1 and CRP; MONO count difference was positively correlated with CRP difference (r = 0.245, P 0.05), but not with CRP 1 and CRP 2.
4. There was no significant difference in peripheral blood MONO (6.52+2.28, 6.06+2.07, 6.57+2.80), MONO count (0.47+0.19, 0.43+0.13, 0.43+0.20) and NIHSS score (4.16+2.50, 4.34+3.01, 3.69+1.82) between the conventional group, berberine group and statin group before treatment.
MONO and MONO in peripheral blood of statin group were significantly increased after treatment (P 0.01, P 0.05). MONO and MONO in peripheral blood of statin group were significantly increased after treatment (P 0.05, P 0.05). MONO and MONO in peripheral blood of berberine group were not significantly increased after treatment (P 6.73 + 2.15, 0.47 + 0.24). Obviously.
The NIHSS scores of the conventional group, berberine group and statin group were significantly lower than those before treatment (P 0.01, P 0.01, P 0.01).
Conclusion:
1. MONO and MONO counts in peripheral blood of patients with acute cerebral infarction increased significantly, suggesting that MONO may participate in the pathophysiological process of acute cerebral infarction.
2. The MONO count in peripheral blood of patients with acute cerebral infarction can reflect the severity of cerebral infarction. The neurological deficit is more serious in patients with high MONO count.
3. The MONO count in peripheral blood of patients with acute cerebral infarction can reflect the degree of inflammation in cerebral infarction. The higher the MONO count in peripheral blood, the more severe the degree of inflammation in cerebral infarction, suggesting that MONO may be closely related to the inflammatory process of acute cerebral infarction.
4. Berberine hydrochloride can inhibit the increase of MONO and MONO counts in peripheral blood of patients with acute cerebral infarction, but Atorvastatin calcium has no such effect, suggesting that berberine hydrochloride may benefit more than Atorvastatin calcium treatment in 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
本文编号：2243570
[Abstract]:AIM: To observe the dynamic changes of peripheral blood mononuclear cell ratio (MONO%) and mononuclear cell (MONO) count in patients with acute cerebral infarction and their relationship with serum C-reactive protein (CRP) level and neurological impairment, and to explore the role of MONO in acute cerebral infarction and its possible pathophysiological mechanism. To investigate the effect of atorvastatin calcium on MONO% and MONO count in patients with acute cerebral infarction and the possible pathophysiological mechanism of berberine hydrochloride and atorvastatin calcium on acute cerebral infarction.
Methods: 75 healthy subjects were selected as control group, 119 patients with acute cerebral infarction within 48 hours after onset were selected as cerebral infarction group, which met the criteria of inclusion and exclusion. The age and sex composition of the two groups were comparable. The cerebral infarction group was randomly divided into routine group (51 cases), berberine group (32 cases) and statin group. The three groups were comparable in age, sex composition and severity of the disease. The MONO% and MONO count in peripheral blood were measured by Japanese Sysmex XE automatic blood cell analyzer and matching reagents ( Changes of MONO% and MONO count in peripheral blood on the 10th day after treatment were assessed with the National Institutes of Health Stroke Scale (NIHSS). All data were processed by SPSS20.0 statistical software. The significant level of the test was bilateral test P0.05..
Result:
1. The MONO% 1 (6.30+2.44) in peripheral blood of cerebral infarction group was slightly lower than that of control group (6.61+2.76), and the MONO count 1 (0.44+0.18) was slightly higher than that of control group (0.40+0.18). The MONO% 2 (7.53+2.21) and MONO 2 (0.50+0.20) in peripheral blood of cerebral infarction group were significantly higher than that of control group (P 0.05, P 0.01). MONO%2, MONO count 2 was significantly higher than MONO%1 and MONO count 1 (P0.01, P0.01).
2. There was no significant correlation between MONO% 1, MONO count 1 and two NIHSS scores (4.07+2.46, 2.58+2.34) and NIHSS difference (1.49+2.00) in cerebral infarction group; MONO% 2 was not significantly correlated with NIHSS2, MONO count 2 was positively correlated with NIHSS2 (r = 0.238, P 0.05); MONO% difference, MONO count was not significantly correlated with two NIHSS scores and NIHSS difference.
3. There was no significant correlation between MONO% in peripheral blood and serum CRP level (2.47 65 MONO count 2 was positively correlated with CRP 2 (r = 0.228, P 0.05), but not with CRP 1 and CRP; MONO count difference was positively correlated with CRP difference (r = 0.245, P 0.05), but not with CRP 1 and CRP 2.
4. There was no significant difference in peripheral blood MONO (6.52+2.28, 6.06+2.07, 6.57+2.80), MONO count (0.47+0.19, 0.43+0.13, 0.43+0.20) and NIHSS score (4.16+2.50, 4.34+3.01, 3.69+1.82) between the conventional group, berberine group and statin group before treatment.
MONO and MONO in peripheral blood of statin group were significantly increased after treatment (P 0.01, P 0.05). MONO and MONO in peripheral blood of statin group were significantly increased after treatment (P 0.05, P 0.05). MONO and MONO in peripheral blood of berberine group were not significantly increased after treatment (P 6.73 + 2.15, 0.47 + 0.24). Obviously.
The NIHSS scores of the conventional group, berberine group and statin group were significantly lower than those before treatment (P 0.01, P 0.01, P 0.01).
Conclusion:
1. MONO and MONO counts in peripheral blood of patients with acute cerebral infarction increased significantly, suggesting that MONO may participate in the pathophysiological process of acute cerebral infarction.
2. The MONO count in peripheral blood of patients with acute cerebral infarction can reflect the severity of cerebral infarction. The neurological deficit is more serious in patients with high MONO count.
3. The MONO count in peripheral blood of patients with acute cerebral infarction can reflect the degree of inflammation in cerebral infarction. The higher the MONO count in peripheral blood, the more severe the degree of inflammation in cerebral infarction, suggesting that MONO may be closely related to the inflammatory process of acute cerebral infarction.
4. Berberine hydrochloride can inhibit the increase of MONO and MONO counts in peripheral blood of patients with acute cerebral infarction, but Atorvastatin calcium has no such effect, suggesting that berberine hydrochloride may benefit more than Atorvastatin calcium treatment in 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
【参考文献】
相关期刊论文 前10条
1 张淑玲;张道培;付胜奇;孙世龙;;急性重症脑卒中患者外周血单核细胞计数的变化及临床意义[J];中国实用神经疾病杂志;2009年11期
2 孟姝;张琳;杨禾;吴亚菲;葛颂;赵蕾;;C-反应蛋白影响单核细胞趋化能力的研究[J];华西口腔医学杂志;2009年06期
3 刘守钾;杨智承;刘苑;谭毓治;;动脉粥样硬化中单核细胞招募与泡沫细胞形成[J];中国动脉硬化杂志;2009年11期
4 潘元美;李焰生;林岩;;炎症因素与脑梗死患者颈动脉粥样硬化的关系[J];临床神经病学杂志;2008年03期
5 林岚;苏美仙;;脑缺血/再灌注损伤机制的研究现状[J];辽宁医学杂志;2013年01期
6 陈永熙;王伟铭;周同;陈楠;;PPAR-γ作用及其相关信号转导途径[J];细胞生物学杂志;2006年03期
7 陆文彬;沈成兴;;细胞因子在单核细胞致动脉硬化中的作用[J];心脏杂志;2011年02期
8 薛静;吕丽霞;;超敏C反应蛋白及血脂与缺血性脑卒中颈动脉粥样硬化的关系[J];血栓与止血学;2007年01期
9 王恩;金国飞;;白细胞与脑梗死[J];心脑血管病防治;2010年05期
10 王嵩;吴伟;刘煜德;黄衍寿;;黄连素对模型小鼠血清IL-1β、Hs-CRP、内膜下单核细胞浸润及热休克蛋白染色的干预作用[J];中国中医药信息杂志;2009年07期
相关博士学位论文 前1条
1 范卫华;IL-1和IL-6基因多态性与冠状动脉粥样硬化性心脏病和慢性牙周炎相关性的研究[D];南方医科大学;2009年
本文编号：2243570
本文链接：https://www.wllwen.com/yixuelunwen/jjyx/2243570.html
最近更新
教材专著
