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急性重癥腦梗死患者S100β蛋白、CRP與神經(jīng)功能缺損程度及預(yù)后的相關(guān)性研究

發(fā)布時(shí)間:2018-06-24 17:27

  本文選題:S100β蛋白 + C反應(yīng)蛋白; 參考:《新鄉(xiāng)醫(yī)學(xué)院》2017年碩士論文


【摘要】:背景:國內(nèi)外研究顯示一些生化標(biāo)志物如S100β蛋白(S100βCalcium-binding protein)、C反應(yīng)蛋白(C-reactive protein,CRP)對急性腦梗死的診斷、病情嚴(yán)重程度及預(yù)后的判斷有積極的幫助,但缺乏對急性重癥腦梗死患者的針對性研究;探究上述指標(biāo)對重癥腦梗死患者病情嚴(yán)重性及短期病情演變的相關(guān)性,將對指導(dǎo)患者的治療方案、了解患者預(yù)后、制定改善預(yù)后的預(yù)防措施起到重要作用。目的:探討急性期血清S100β蛋白、CRP濃度與急性重癥腦梗死患者入院時(shí)神經(jīng)功能缺損程度及預(yù)后的關(guān)系。方法:(1)收集急性重癥腦梗死患者40例,入院當(dāng)天采集靜脈血,ELISA法測定血清S100β蛋白及血清CRP濃度,采用美國國立衛(wèi)生研究院卒中量表(National Institute of Health stroke scale,NIHSS)對入選者神經(jīng)功能缺損程度進(jìn)行評估,并收集同期輕型急性腦梗死患者37例;(2)分別在入院后30天、90天對重癥腦梗死患者進(jìn)行面對面或電話隨訪,應(yīng)用改良Ranking量表(modified Ranking Scale,mRS)對患者神經(jīng)功能恢復(fù)情況進(jìn)行評估,探討急性期血清S100β蛋白、CRP濃度與急性重癥腦梗死患者預(yù)后的關(guān)系;(3)根據(jù)兩次隨訪評分變化情況將患者病情變化趨勢分為死亡、惡化、穩(wěn)定及改善,探討急性期血清S100β蛋白、CRP濃度與急性重癥腦梗死患者90天內(nèi)病情變化之間的關(guān)系。結(jié)果:(1)急性期血清CRP水平與患者神經(jīng)功能缺損程度呈正相關(guān)性,血清S100β蛋白水平與患者神經(jīng)功能缺損程度之間無相關(guān)性,且血清S100β蛋白水平與CRP水平之間無相關(guān)性;(2)急性期血清CRP水平分別與患者30天、90天預(yù)后呈正相關(guān)性,血清S100β蛋白水平與患者30天、90天預(yù)后之間無相關(guān)性;(3)急性重癥腦梗死患者血清CRP濃度與90天內(nèi)病情變化情況呈負(fù)相關(guān)性。結(jié)論:(1)急性期高血清CRP水平與急性重癥腦梗死患者神經(jīng)功能缺損嚴(yán)重程度及90天內(nèi)不良預(yù)后呈正相關(guān);(2)血清S100β蛋白與重癥腦梗死患者神經(jīng)功能缺損嚴(yán)重程度及預(yù)后無明顯相關(guān)性。
[Abstract]:Background: studies at home and abroad show that some biochemical markers, such as S100 尾 Calcium-binding protein (S100 尾 -Calcium-binding protein) C-reactive protein (CRP), are helpful in the diagnosis, severity and prognosis of acute cerebral infarction. However, there is a lack of targeted research on the patients with acute severe cerebral infarction, to explore the correlation between the above indexes and the severity of the disease and the short-term development of the patients, which will guide the treatment plan of the patients and understand the prognosis of the patients. Making preventive measures to improve prognosis plays an important role. Objective: to investigate the relationship between the concentration of serum S100 尾 protein and CRP in patients with acute severe cerebral infarction. Methods: (1) 40 patients with acute severe cerebral infarction were collected. The serum S100 尾 protein and serum CRP were measured by Elisa on the day of admission. The National Institute of Health stroke scale (NIHSS) was used to evaluate the degree of neurological impairment in the selected patients. 37 patients with mild acute cerebral infarction in the same period were collected. (2) face to face or telephone follow-up of patients with severe cerebral infarction were carried out 30 days after admission and 90 days after admission, and the neurological function recovery was evaluated by modified ranking scale (RS). To investigate the relationship between serum S100 尾 protein CRP concentration and prognosis of patients with acute severe cerebral infarction (ACI). (3) according to the changes of two follow-up scores, the patients were divided into death, deterioration, stability and improvement. To investigate the relationship between serum S100 尾 protein and CRP in patients with acute severe cerebral infarction within 90 days. Results: (1) the level of serum CRP was positively correlated with the degree of neurological impairment in patients with acute stage, but there was no correlation between the level of serum S100 尾 protein and the degree of neurological impairment in patients. There was no correlation between serum S100 尾 protein level and CRP level. (2) there was a positive correlation between serum CRP level in acute phase and prognosis of 30 days and 90 days, respectively. There was no correlation between serum S100 尾 protein level and prognosis of 30 days and 90 days. (3) there was a negative correlation between serum CRP concentration and the state of disease within 90 days after acute severe cerebral infarction. Conclusion: (1) the high serum CRP level in acute stage is positively correlated with the severity of neurological deficit and the poor prognosis in 90 days in patients with acute severe cerebral infarction, (2) the level of serum S100 尾 protein is positively correlated with the severity of neurological impairment and preconditioning in patients with severe cerebral infarction. There was no significant correlation after operation.
【學(xué)位授予單位】:新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級別】:碩士
【學(xué)位授予年份】:2017
【分類號】:R743.3

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