本文關(guān)鍵詞： 尤瑞克林 急性腦梗死 細(xì)胞凋亡 B淋巴細(xì)胞瘤-2蛋白 細(xì)胞色素C　出處：《河北醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:急性腦梗死是導(dǎo)致人類死亡和致殘的主要原因之一,其高發(fā)病率和高復(fù)發(fā)率對人們的健康和生活產(chǎn)生了嚴(yán)重的影響。目前很多學(xué)者認(rèn)為抑制神經(jīng)細(xì)胞凋亡從而改善神經(jīng)功能缺失是治療急性腦梗死的重要目標(biāo),本實驗旨在研究尤瑞克林對急性腦梗死后細(xì)胞凋亡相關(guān)因子的影響及其作用機制的探討。在實驗中利用NIHSS評分觀察對比用藥前后患者神經(jīng)功能改善的程度,并通過檢測患者血清中B淋巴細(xì)胞瘤-2(Bcl-2)蛋白、細(xì)胞色素C(Cyt C)濃度的變化,探究尤瑞克林應(yīng)用前后關(guān)于神經(jīng)細(xì)胞凋亡的情況,以及進一步探討尤瑞克林對急性腦梗死后細(xì)胞凋亡抑制作用的可能機制。方法:收集2015年1月至2015年10月期間就診于河北醫(yī)科大學(xué)第二醫(yī)院神經(jīng)內(nèi)科的首次發(fā)病的急性腦梗死患者100例,將其隨機分為尤瑞克林組和常規(guī)治療組。以入院當(dāng)天為起始,分別在第1天、14天和3個月時對兩組患者進行NIHSS評分,并留取空腹靜脈血5ml,在分離上層血清后,用酶聯(lián)免疫吸附法(ELISA)檢測血清中Bcl-2蛋白、Cyt C的含量。結(jié)果:1一般資料:本實驗共納入了100例急性腦梗死患者,均符合納入標(biāo)準(zhǔn),兩組患者在年齡、性別、文化程度等方面均無統(tǒng)計學(xué)差異(P0.05),具有可比性。但由于個別患者病情加重及依從性差等原因,共22例患者在實驗第14天前脫組,以至于在住院期間能按預(yù)計進行實驗的患者包括尤瑞克林組45例,常規(guī)治療組33例,兩組入院時NIHSS評分無統(tǒng)計學(xué)差異(P0.05)。2臨床療效評價:兩組患者在入院時NIHSS評分無統(tǒng)計學(xué)差異(P0.05),在14天及3個月時均較入院時有所下降,前后相比均有統(tǒng)計學(xué)差異(P0.05)。與常規(guī)治療組相比,尤瑞克林組的臨床療效更明顯,并且有統(tǒng)計學(xué)差異(P0.05)。3血清Bcl-2蛋白含量的測定:入院時兩組患者血清Bcl-2蛋白含量無統(tǒng)計學(xué)差異(P0.05),隨著時間的變化,尤瑞克林組中患者血清中Bcl-2含量先上升后下降,前后相比均有統(tǒng)計學(xué)差異(P0.05)。常規(guī)治療組中患者Bcl-2蛋白含量一直下降,前后相比均無統(tǒng)計學(xué)差異(P0.05)。在第14天時兩組相比有統(tǒng)計學(xué)差異(P0.05),3個月時兩組相比有統(tǒng)計學(xué)差異(P0.05)。4血清Cyt C含量的測定:入院時兩組患者血清中Cyt C含量無統(tǒng)計學(xué)差異(P0.05)。隨著時間的變化,尤瑞克林組中患者血清中Cyt C含量先下降后上升,前后相比均有統(tǒng)計學(xué)差異(P0.05)。常規(guī)治療組中患者Cyt C含量先上升后下降,前后相比均無統(tǒng)計學(xué)差異(P0.05)。在第14天時兩組相比有統(tǒng)計學(xué)差異(P0.05),3個月時兩組相比無統(tǒng)計學(xué)差異(P0.05)。結(jié)論:1尤瑞克林可以明顯減輕急性腦梗死患者的神經(jīng)功能缺失癥狀,且在3個月時仍有明顯作用。2尤瑞克林可以通過抑制神經(jīng)細(xì)胞凋亡而改善神經(jīng)功能。3通過調(diào)節(jié)Bcl-2蛋白表達、減少線粒體中Cyt C釋放到細(xì)胞質(zhì)中,從而抑制半胱天冬酶(caspase)級聯(lián)反應(yīng),可能是尤瑞克林抑制細(xì)胞凋亡的重要作用機制之一。
[Abstract]:Objective: acute cerebral infarction is one of the main causes of human death and disability. Its high incidence and high recurrence rate have a serious impact on people's health and life. At present, many scholars think that inhibition of neuronal apoptosis and improvement of neural function is an important goal in the treatment of acute cerebral infarction. The purpose of this study was to investigate the effect of eurexine on apoptosis related factors after acute cerebral infarction and its mechanism. To observe and compare the course of nerve function improvement before and after treatment with NIHSS score in the experiment. Degree. The changes of serum B lymphocytoma Bcl-2) protein and cytochrome C (Cyt C) concentration were detected to explore the apoptosis of nerve cells before and after eurekline application. To explore the possible mechanism of eurexine on the inhibition of apoptosis after acute cerebral infarction. Methods:. From January 2015 to October 2015, 100 patients with acute cerebral infarction (ACI) who were first diagnosed in the Department of Neurology, second Hospital of Hebei Medical University were collected. The patients were randomly divided into two groups: eurexine group and routine treatment group. The patients in the two groups were assessed with NIHSS on day 1, day 14 and month 3, respectively, and the fasting venous blood was kept at 5 ml. The Bcl-2 protein in serum was detected by enzyme linked immunosorbent assay (Elisa) after isolation of the upper serum. Cyt C content. Results: one hundred patients with acute cerebral infarction were included in this study, all of whom were in accordance with the inclusion criteria. The two groups of patients were in age and sex. There was no significant difference in education level between two groups (P 0.05), which was comparable. However, due to the aggravation and poor compliance of individual patients, a total of 22 patients were removed from the group before the 14th day of the experiment. The patients who were able to conduct the trials as expected during hospitalization included 45 patients in the Urekline group and 33 in the routine treatment group. There was no significant difference in NIHSS scores between the two groups at admission (P 0.05). There was no significant difference in NIHSS scores between the two groups at admission (P 0.05). After 14 days and 3 months compared with the admission, there was a statistical difference between the two groups (P 0.05). Compared with the routine treatment group, the clinical effect of Urikline group was more obvious. And there was a statistical difference in serum Bcl-2 protein content: there was no significant difference in serum Bcl-2 protein content between the two groups on admission (P0.05). With the change of time, the serum Bcl-2 content in eurekline group increased first and then decreased. There was significant difference between the two groups (P 0.05). The content of Bcl-2 protein in the routine treatment group had been decreasing. There was no statistical difference between the two groups before and after, and there was a statistical difference between the two groups on the 14th day (P0.05). Measurement of serum Cyt C levels in two groups at 3 months after admission: there was no significant difference in Cyt C levels between the two groups at admission (P 0.05). Over time. The level of serum Cyt C in Urekline group decreased first and then increased, and there was statistical difference between before and after. The Cyt C content of patients in routine treatment group increased first and then decreased. There was no statistical difference between the two groups before and after, and there was a statistical difference between the two groups on the 14th day (P0.05). There was no statistical difference between the two groups at 3 months. Conclusion: 1 / 1 eucrine can significantly alleviate the neurological deficit symptoms in patients with acute cerebral infarction. At 3 months, Eucrine could improve the neural function by inhibiting neuronal apoptosis and regulating the expression of Bcl-2 protein. Reducing the release of Cyt C from mitochondria into the cytoplasm, thus inhibiting the cascade of cysteinase caspase, may be one of the important mechanisms by which eucrine inhibits cell apoptosis.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R743.3

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