本文選題：急性腦梗死 + 鹽酸小檗堿��； 參考：《大連醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的：觀察急性腦梗死患者外周血嗜堿性粒細(xì)胞比例（BASO%），嗜堿性粒細(xì)胞計(jì)數(shù)（BASO計(jì)數(shù)）的動(dòng)態(tài)變化，比較鹽酸小檗堿與阿托伐他汀鈣對前述指標(biāo)的影響，探討B(tài)ASO%、BASO計(jì)數(shù)與神經(jīng)功能缺損程度及血清誘導(dǎo)型一氧化氮合酶（iNOS）水平的關(guān)系，并進(jìn)一步探討鹽酸小檗堿與阿托伐他汀鈣對急性腦梗死的作用及其可能的病理生理機(jī)制。 方法：選擇健康體檢者75例為對照組，發(fā)病48小時(shí)內(nèi)的急性腦梗死患者119例為腦梗死組，均符合入組標(biāo)準(zhǔn)和排除標(biāo)準(zhǔn)，兩組在年齡、性別構(gòu)成、伴發(fā)糖尿病情況方面具有可比性。采用對照研究的方法，根據(jù)治療方案的不同，將腦梗死組隨機(jī)分為常規(guī)組（51例）、小檗堿組（32例）和他汀組（36例），三組在年齡、性別構(gòu)成及病情嚴(yán)重程度方面具有可比性。用日本sysmex XE型全自動(dòng)血細(xì)胞分析儀及配套試劑檢測外周血BASO%、BASO計(jì)數(shù)（×109/L），采用化學(xué)比色法測定血清iNOS水平（U/ml），觀察發(fā)病48小時(shí)內(nèi)（治療前）及入院后第10天（治療后）外周血BASO%、BASO計(jì)數(shù)變化。對腦梗死組患者的神經(jīng)功能缺失程度采用美國國立衛(wèi)生研究院卒中量表（NIHSS）進(jìn)行評定，分別于治療前后各評定一次。第一次（治療前）結(jié)果記為“1”，第二次（治療后）結(jié)果記為“2”.所有數(shù)據(jù)采用SPSS20.0統(tǒng)計(jì)軟件進(jìn)行處理，檢驗(yàn)顯著性水準(zhǔn)為雙側(cè)檢驗(yàn)P0.05。 結(jié)果： 1、腦梗死組外周血BASO%1（0.200±0.288）、BASO%2（0.300±0.300）、BASO計(jì)數(shù)1（0.012±0.022）與對照組（0.281±0.206，0.017±0.013）比較無顯著差異，，BASO計(jì)數(shù)2（0.020±0.021）與對照組比較顯著升高（P0.05）。 2、腦梗死組外周血BASO%1、BASO%2、BASO計(jì)數(shù)1、BASO計(jì)數(shù)2與兩次NIHSS評分（4.070±2.462,2.580±2.338）呈正相關(guān)趨勢（相關(guān)系數(shù)為正），但相關(guān)不顯著。 腦梗死組外周血BASO%1、兩次BASO計(jì)數(shù)與iNOS1（18.007±5.889）、iNOS2（14.411±7.556）呈正相關(guān)趨勢（相關(guān)系數(shù)為正），但相關(guān)不顯著，BASO%2與iNOS1、iNOS2呈顯著正相關(guān)（r=0.300、0.251，均為P0.05）。 3、常規(guī)組、小檗堿組及他汀組治療前外周血BASO%1（0.200±0.250，0.268±0.254，0.252±0.258）、BASO計(jì)數(shù)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）無顯著差異。 常規(guī)組外周血BASO%2（0.300±0.350）、BASO計(jì)數(shù)2（0.020±0.026）較BASO%1、BASO計(jì)數(shù)1明顯升高（P0.01），他汀組外周血BASO%2（0.393±0.220）、BASO計(jì)數(shù)2（0.025±0.013）較BASO%1、BASO計(jì)數(shù)1明顯升高（P0.01），小檗堿組外周血BASO%2（0.285±0.315）、BASO計(jì)數(shù)2（0.019±0.021）較BASO%1、BASO計(jì)數(shù)1升高不明顯。 常規(guī)組、他汀組、小檗堿組NIHSS2（3.000±2.698，2.030±2.197，2.530±1.722）較NIHSS1明顯降低，差異有統(tǒng)計(jì)學(xué)意義（均為P0.01）。 結(jié)論： 1.急性腦梗死患者外周血BASO計(jì)數(shù)顯著升高，提示BASO可能參與了急性腦梗死的病理生理過程。 2.急性腦梗死患者外周血BASO%與血清iNOS水平呈顯著正相關(guān)，提示兩者在急性腦梗死的病理生理過程中可能有密切的聯(lián)系。 3.鹽酸小檗堿可以抑制急性腦梗死患者外周血BASO%、BASO計(jì)數(shù)的升高，阿托伐他汀鈣則無此作用，確切的臨床意義有待于進(jìn)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 鹵 0.288 ) , BASO % 2 ( 0.300 鹵 0.300 ) , BASO count ( 0 . 012 鹵 0 . 022 ) and control group ( 0 . 281 鹵 0 . 206 , 0 . 017 鹵 0 . 013 ) . BASO count 2 ( 0.020 鹵 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 鹵 2.462 , 2.580 鹵 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 鹵 5.889 ) and iNOS2 ( 14.411 鹵 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 鹵 0.250 , 0.268 鹵 0.254 , 0.252 鹵 0.258 ) , BASO count 1 ( 0 . 011 鹵 0 . 017 , 0 . 018 鹵 0 . 018 , 0.015 鹵 0.015 ) and NIH 1 ( 4 . 160 鹵 2 . 493 , 4 . 340 鹵 3 . 012 , 3 . 690 鹵 1 . 818 ) .

BASO % 2 ( 0.393 鹵 0.220 ) , BASO count 2 ( 0.025 鹵 0 . 013 ) , BASO % 2 ( 0 . 285 鹵 0 . 315 ) , BASO count 2 ( 0.019 鹵 0.021 ) and BASO % 1 , BASO count 1 were significantly higher than that of BASO % 1 and BASO % 1 , BASO % 2 ( 0 . 285 鹵 0 . 315 ) , BASO count 2 ( 0.019 鹵 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 鹵 2.698 , 2.030 鹵 2.197 , 2.530 鹵 1.722 ) decreased significantly in the conventional group , the berberine group , the berberine group ( 3.000 鹵 2.698 , 2.030 鹵 2.197 , 2.530 鹵 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 .

【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R743.33

【參考文獻(xiàn)】

中國期刊全文數(shù)據(jù)庫 前10條

1 吳海雄;黃建輝;;阿托伐他汀對急性腦梗死患者血清hs-CRP和S-100β蛋白的作用[J];白求恩軍醫(yī)學(xué)院學(xué)報(bào);2011年04期

2 于艷秋;張?zhí)m;;阿托伐他汀治療老年腦梗死患者炎癥反應(yīng)的臨床療效[J];廣東醫(yī)學(xué);2005年12期

3 錢R季

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