本文選題：急性腦梗死 + 腦損傷��； 參考：《鄭州大學》2013年碩士論文

【摘要】：背景和目的 S100B蛋白是一種小分子酸性鈣結合蛋白,主要存在于神經(jīng)膠質(zhì)細胞、星形膠質(zhì)細胞和Schwann細胞。它在S100蛋白一大家族中占絕大部分,活性也最高,在中樞神經(jīng)系統(tǒng)損傷中高度特異,是神經(jīng)膠質(zhì)細胞活化和(或)損傷的重要標志之一。 本研究通過探討急性腦梗死患者血清S100B蛋白水平的變化,以及血清S100B蛋白水平在急性腦梗死患者中不同梗死面積及不同梗死部位的變化及其與神經(jīng)功能缺損程度的關系,分析和評價血清S100B蛋白在急性腦梗死患者中的水平變化及其臨床意義。 對象和方法 1.研究對象和分組：收集2012年2月-2013年1月在鄭州大學第二附屬醫(yī)院神經(jīng)內(nèi)科就診的86例急性腦梗死(發(fā)病后48h內(nèi)入院)患者的臨床資料,將其作為病例組,診斷符合《中國急性缺血性腦卒中診治指南2010))的診斷標準,并經(jīng)核磁共振成像(MRI)或者計算機斷層掃描(CT)檢查明確診斷。將同期在鄭州大學第二附屬醫(yī)院體檢的68例健康體檢者作為對照組。 根據(jù)病例組的梗死面積再分為小面積梗死組、中等面積梗死組及大面積梗死組。最后根據(jù)病例組的梗死部位分為皮質(zhì)梗死組(包括額葉、頂葉、顳葉、枕葉)、皮質(zhì)下梗死組(包括腦干、基底節(jié)區(qū)、丘腦、內(nèi)囊等)、皮質(zhì)和皮質(zhì)下梗死組(皮質(zhì)和皮質(zhì)下同時梗死)、小腦梗死組。 2.研究方法：病例組記錄其性別、年齡、梗死面積、梗死部位,病例組患者發(fā)病后48±2h抽血送檢S100B蛋白,同時由神經(jīng)內(nèi)科專業(yè)醫(yī)師進行全面神經(jīng)系統(tǒng)檢查,并即刻行NIHSS評分。對照組記錄其性別、年齡,并檢測血清S100B蛋白含量。 3.統(tǒng)計處理：應用SPSS17.0軟件進行統(tǒng)計學分析。對計量資料用均數(shù)±標準差(x±s)表示。兩組計量資料比較用t檢驗,多組間數(shù)據(jù)比較用單因素方差分析,S100B蛋白與NIHSS評分的相關性比較采用Pearson相關分析,P0.05時認為有統(tǒng)計學意義。 結果 1.病例組與對照組比較,年齡、性別差異無統(tǒng)計學意義(P0.05)。86例急性腦梗死患者中,小面積梗死組44例,占51.2%,中等面積梗死組32例,占37.2%,大面積梗死組10例,占11.6%。皮質(zhì)梗死組12例,占14%,皮質(zhì)下梗死組42例,占48.8%,小腦梗死組14例,占16.3%,皮質(zhì)和皮質(zhì)下梗死組18例,占20.9%。 2.病例組血清S100B蛋白含量(172.42±49.88ng/L)明顯高于對照組(38.86±12.90ng/L),兩組間血清S100B蛋白含量比較具有統(tǒng)計學意義(P0.05)。 3.病例組中小面積梗死組、中等面積梗死組和大面積梗死組的S100B蛋白含量組間比較,差異有顯著性(P0.05),隨著梗死面積的增大,S100B蛋白含量明顯升高；各組間NIHSS評分也具有顯著差異(P0.05),也隨著梗死面積的增大而增高。 4.急性腦梗死患者中,皮質(zhì)、皮質(zhì)下梗死組的S100B蛋白含量顯著高于其余三組(P0.05),皮質(zhì)梗死組的S100B蛋白含量與皮質(zhì)下梗死組和小腦梗死組組間比較差異無統(tǒng)計學意義(P0.05)。四組間NIHSS評分比較,皮質(zhì)、皮質(zhì)下梗死組的NIHSS評分顯著高于其余三組(P0.05),皮質(zhì)梗死組與皮質(zhì)下梗死組和小腦梗死組組間比較差異無統(tǒng)計學意義(P0.05)。 5.病例組中血清S100B蛋白含量與NIHSS評分的相關性,經(jīng)Pearson相關性分析,相關系數(shù)r=0.653,P0.05,即血清S100B蛋白水平與入院時NIHSS評分呈正相關。 結論 1.急性腦梗死患者血清S100B蛋白水平明顯升高,且與腦梗死后腦損傷的嚴重程度相關。 2.隨著梗死面積的增大,血清S100B蛋白含量也相應升高,相對應的神經(jīng)功能缺損評分也增大。 3.血清S100B蛋白含量與腦梗死的梗死部位無關。 4.血清S100B蛋白含量與NIHSS評分呈正相關。
[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.
【學位授予單位】：鄭州大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R743.33

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