二丁酰环磷腺苷钙对脑梗死患者脑脊液中神经细胞子的影响

发布时间：2018-05-28 02:36

本文选题：脑梗死 + 血管内皮生长因子　；参考：《新乡医学院》2014年硕士论文

【摘要】：背景脑梗死对人们身体健康的危害近年来一直位居榜首,其预后直接影响到患者今后的日常生活和家庭生活。脑组织的缺血、缺氧是脑梗死最常见的损害,改善脑组织的缺血、缺氧状态、减轻脑水肿是治疗脑梗死不可缺少的手段,血管内皮生长因子(VEGF)能够加速缺血、缺氧区新血管的再生、重建；脑梗死发生后,脑组织中的炎症因子也被激活,如白细胞介素-8(IL-8)、白细胞介素-17(IL-17)等,它们对白细胞有着强烈的趋化作用,这些炎症因子聚集在一起,又反过来加重了脑血管的堵塞,进一步加重了脑组织的缺血、缺氧状态；如何同时能激活VEGF.抑制IL-8、IL-17等炎症因子显得尤为重要。近年来,大量事实证明环磷腺苷参与多种被损伤的神经系统的修复,环磷腺苷是核苷酸的衍生物,人们称之为第二信使,环磷腺苷的稳定取决于腺苷酸环化酶和磷酸二酯酶的功能状态。研究表明,环磷腺苷能影响神经细胞膜蛋白的结构和功能,阻止Ca2+内流,抑制各种有害因子的表达和产生,如IL等,激活有益因子如VEGF等,促进血管再生和重建,阻止神经元细胞的凋亡。目前关于环磷腺苷对血清中VEGF、IL影响的研究较多,对脑脊液中VEGF、IL影响的研究较少。目的分析二丁酰环磷腺苷钙对急性脑梗死患者脑脊液中神经细胞因子的影响。方法采用随机数字表法将我院神经内科2012年4月至2014年8月期间105例确诊急性脑梗死住院患者进行分组,对照组52例给予胞二磷胆碱治疗,试验组53例给予环磷腺苷的衍生物——二丁酰环磷腺苷钙治疗,观察治疗后3天、7天、14天患者脑脊液中VEGF、IL-8、IL-17的变化趋势,比较两组研究对象在不同的治疗时期三个观察指标的差异,来判断二丁酰环磷腺苷钙在脑梗死患者早期治疗过程中的价值。结果1.与对照组相比,脑梗死患者在使用二丁酰环磷腺苷钙治疗3天、7天后,VEGF明显升高,两组比较差异有统计学意义；治疗14天后,VEGF恢复至治疗前水平,两组比较差异无统计学意义：2.与对照组相比,试验组IL-8、IL-17在治疗3天后显著下降,两组比较差异有统计学意义,在治疗7天、14天后降至正常水平,两组比较差异无统计学意义。结论1.二丁酰环磷腺苷钙可升高VEGF水平,有可能改善脑梗死患者脑组织的缺氧缺血状态。2.二丁酰环磷腺苷钙能降低IL-8、IL-17水平,有可能减轻脑梗死患者脑组织的炎症反应。3.二丁酰环磷腺苷钙可能促进脑梗死患者神经功能的康复和局部血管的再生。
[Abstract]:Background Cerebral infarction has been the most harmful to people's health in recent years, and its prognosis has a direct impact on patients' daily life and family life. Cerebral ischemia and hypoxia are the most common lesions in cerebral infarction. Improving cerebral ischemia and hypoxia, reducing cerebral edema is an indispensable means to treat cerebral infarction. Vascular endothelial growth factor (VEGF) can accelerate ischemia. The regeneration and reconstruction of new blood vessels in the anoxic region, and the activation of inflammatory factors in the brain after cerebral infarction, such as interleukin-8, interleukin-17 (IL-17), which have a strong chemotactic effect on white blood cells, and these inflammatory factors gather together. In turn, it exacerbates the blockage of cerebral vessels, further exacerbates the ischemic and anoxic state of brain tissue, and how to activate VEGFat at the same time. It is very important to inhibit the inflammatory factors such as IL-8, IL-17 and so on. In recent years, a large number of facts have proved that adenosine is involved in the repair of many damaged nervous systems. Adenosine monophosphate is a derivative of nucleotides, which is called the second messenger. The stability of cyclic adenosine depends on the functional state of adenylate cyclase and phosphodiesterase. Studies have shown that cyclophosphate adenosine can affect the structure and function of membrane proteins of nerve cells, block the influx of Ca2, inhibit the expression and production of various harmful factors, such as IL, activate beneficial factors such as VEGF, and promote vascular regeneration and reconstruction. Block neuronal cell apoptosis. At present, there are more studies on the effect of cyclic adenosine on VEGF IL in serum, and less on the effect of VEGF IL in CSF. Objective to analyze the effect of dibutyryl cyclic adenosine phosphate calcium on neurocytokines in cerebrospinal fluid (CSF) of patients with acute cerebral infarction. Methods from April 2012 to August 2014, 105 inpatients with acute cerebral infarction were randomly divided into two groups. 52 patients in control group were treated with citicoline. 53 patients in the experimental group were treated with calcium dibutyryl cyclic adenosine monophosphate. The changes of IL-17 in cerebrospinal fluid (CSF) of 53 patients with adenosine cyclophosphate were observed 3 days after treatment and 14 days after treatment, and the changes of IL-17 in cerebrospinal fluid of patients with adenosine cyclophosphate were observed. To evaluate the value of calcium dibutyrylcyclophosphate in the early treatment of cerebral infarction patients, we compared the difference of three observation indexes between the two groups in different treatment period. Result 1. Compared with the control group, VEGF in cerebral infarction patients increased significantly after 3 days and 7 days of treatment, the difference between the two groups was statistically significant, 14 days after treatment, VEGF returned to the level before treatment, and there was no significant difference between the two groups. Compared with the control group, IL-8 IL-17 in the experimental group decreased significantly after 3 days of treatment, the difference between the two groups was statistically significant, and the level of IL-8 IL-17 decreased to the normal level after 7 days and 14 days of treatment, but there was no significant difference between the two groups. Conclusion 1. Calcium dibutyrylcyclophosphate can increase the level of VEGF, which may improve the hypoxic-ischemic state of cerebral tissue in patients with cerebral infarction. Calcium dibutyrylcyclophosphate can decrease the level of IL-8 and IL-17, which may alleviate the inflammatory reaction of cerebral tissue in patients with cerebral infarction. Dibutyryl cyclophosphate calcium may promote the rehabilitation of nerve function and the regeneration of local blood vessels in patients with cerebral infarction.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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