急性脑出血患者血浆、脑脊液β-内啡肽、GnRH水平变化对脑损伤程度及预后的影响

发布时间：2018-05-11 11:04

本文选题：急性脑出血 + β-内啡肽　；参考：《山东医药》2017年29期

【摘要】：目的探讨急性脑出血(ICH)患者血浆和脑脊液中β-内啡肽、促性腺激素释放激素(GnRH)水平变化及其对脑损伤程度和预后的影响。方法 89例ICH患者为病例组,按照斯堪的纳维亚卒中量表(SSS)评分将其分为轻型ICH组(SSS评分0~15分,n=41)、中型ICH组(SSS评分16~30分,n=28)、重型ICH组(SSS评分31~45分,n=20例),按照格拉斯哥预后量表(GOS)评分将其分为预后良好组(GOS评分4~5分,n=63)、预后不良组(GOS评分1~3分,n=26)。采用放射免疫法对患者入院后1、3、7、14、30 d血浆和脑脊液中β-内啡肽、GnRH水平进行检测。并于同期选取30例无神经系统疾病且行腰穿麻醉术的患者为对照组。结果随着入院时间延长,轻型、中型、重型ICH患者血浆、脑脊液中β-内啡肽、GnRH水平均呈逐渐下降趋势(P均0.05)。病例组入院后1、3、7、14 d血浆、脑脊液β-内啡肽、GnRH水平均高于对照组(P均0.05),轻型、中型、重型ICH组间两两比较,P均0.05。入院30 d时,中型、重型ICH组血浆、脑脊液β-内啡肽、GnRH水平高于轻型ICH组、对照组,重型ICH组血浆、脑脊液β-内啡肽、GnRH水平高于中型ICH组(P均0.05)。预后良好组入院1、3、7、14、30 d血浆、脑脊液β-内啡肽、GnRH水平均低于预后不良组(P均0.05)。结论 ICH患者血浆和脑脊液中β-内啡肽、GnRH水平升高,其水平升高可致脑损伤程度加重,预后变差。
[Abstract]:Objective to investigate the changes of 尾 -endorphin and gonadotropin releasing hormone (GnRH) in plasma and cerebrospinal fluid (CSF) of patients with acute cerebral hemorrhage (ICH) and their effects on the degree of brain injury and prognosis. Methods Eighty-nine patients with ICH were enrolled in the study. According to the Scandinavian Stroke scale (SSS) score, it was divided into mild ICH group (0 ~ 15), moderate ICH group (16 ~ 30%) and severe ICH group (31 ~ 45 cases). They were classified as prognosis according to Glasgow prognosis scale (Glasgow prognosis scale) score. In the good group, the GOS score ranged from 4 to 5, and the GOS score was 1 ~ 3 in the poor prognosis group. The levels of 尾 -endorphin GnRH in plasma and cerebrospinal fluid (CSF) were measured by radioimmunoassay on 30 days after admission. At the same time, 30 patients without nervous system disease and undergoing lumbar anesthesia were selected as control group. Results the levels of 尾 -endorphin GnRH in plasma and cerebrospinal fluid (CSF) of patients with mild, moderate and severe ICH showed a decreasing trend with the prolongation of admission time (P < 0.05). The levels of 尾 -endorphin GnRH in cerebrospinal fluid (CSF) were significantly higher in the case group than those in the control group (P < 0.05) on the 14th day after admission, and were significantly higher than those in the control group (P < 0.05), and were significantly higher in the mild, moderate and severe ICH groups than in the other two groups (P < 0.05). 30 days after admission, the plasma and cerebrospinal fluid 尾 -endorphin GnRH levels in moderate and severe ICH group were higher than those in mild ICH group. The plasma and cerebrospinal fluid 尾 -endorphin GnRH levels in control group and severe ICH group were higher than those in moderate ICH group (P < 0.05). The levels of 尾 -endorphin GnRH in cerebrospinal fluid (CSF) were lower than those in patients with poor prognosis (P < 0.05). Conclusion the level of 尾 -endorphin GnRH in plasma and cerebrospinal fluid of patients with ICH is increased, which can lead to severe brain injury and poor prognosis.
【作者单位】：青海红十字医院;
【基金】：青海省卫生计生指导性基金资助项目(2015KRB02964)
【分类号】：R743.34

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