本文選題：腦外傷　切入點(diǎn)：CXCL　出處：《中國康復(fù)理論與實(shí)踐》2017年08期 　論文類型：期刊論文

【摘要】：目的研究趨化因子CXCL1在重度腦外傷(TBI)患者腦組織中的細(xì)胞定位及在腦組織和血液中的表達(dá),探討其與損傷嚴(yán)重程度的關(guān)系。方法 2013年9月至2015年10月,選取重度TBI住院、且行開顱手術(shù)患者78例為實(shí)驗(yàn)組,所有患者均收集血液,其中19例收集到腦組織。實(shí)驗(yàn)組根據(jù)入院時(shí)格拉斯哥昏迷量表(GCS)評(píng)分分為重型TBI組(6~8分,n=35)和特重型TBI組(3~5分,n=43)。10例病例對(duì)照組腦組織標(biāo)本來自摘除的腦血管瘤或良性腫瘤邊緣少量正常腦組織。10例健康對(duì)照組血液來自同期在本院健康體檢正常者。采用免疫熒光雙標(biāo)法檢測(cè)重度TBI患者CXCL1在腦組織中的細(xì)胞定位;ELISA法檢測(cè)損傷后腦組織和不同時(shí)間點(diǎn)血液中CXCL1蛋白的表達(dá);Spearman相關(guān)分析對(duì)不同時(shí)間點(diǎn)外周血中CXCL1蛋白含量與術(shù)后30 d格拉斯哥結(jié)局量表(GOS)評(píng)分進(jìn)行相關(guān)性分析。結(jié)果正常腦組織內(nèi)CXCL1主要表達(dá)在星形膠質(zhì)細(xì)胞;重度TBI后,CXCL1主要表達(dá)在神經(jīng)元和星形膠質(zhì)細(xì)胞。特重型TBI組CXCL1蛋白在腦組織中的含量高于重型TBI組(t=-12.58,P0.05)。重型TBI組CXCL1蛋白在血液中含量于術(shù)前達(dá)高峰,隨后逐漸下降,術(shù)后14 d仍高于健康對(duì)照組(P0.05),術(shù)后30 d降至健康者水平(P0.05)。特重型TBI組CXCL1蛋白在血液中含量術(shù)前和術(shù)后1 d最高,其后逐漸下降,術(shù)后30 d仍高于健康者(P0.05)。術(shù)前至術(shù)后30 d,特重型TBI組CXCL1蛋白含量均高于重型TBI組(P0.05)。特重型TBI組術(shù)前血液中CXCL1蛋白含量與GOS評(píng)分呈負(fù)相關(guān)(r=-0.351,P0.05)。結(jié)論重度TBI后CXCL1表達(dá)明顯增高,且主要表達(dá)在神經(jīng)元和星形膠質(zhì)細(xì)胞,同時(shí)CXCL1含量在一定程度上可以反映腦損傷的嚴(yán)重程度和預(yù)后。
[Abstract]:Objective to study the chemokine CXCL1 in patients with severe brain injury (TBI) in brain tissue of patients with cellular localization and expression in brain tissue and blood, and explore their relationship with the severity of brain injury. Methods from September 2013 to October 2015, selection of severe TBI in hospital, and underwent craniotomy in 78 patients as the experimental group, all patients were collected the blood, among which 19 cases were collected from brain tissue in experimental group. According to the Glasgow Coma Scale (GCS) scores were divided into severe TBI group (6~8, n=35) and severe TBI group (3~5, n=43).10 cases control group brain tissue samples from the removed edge of cerebral aneurysm or benign tumor a small amount of normal brain tissue.10 controls the blood from the same period in the health examination in our hospital. The normal cellular localization by immunofluorescence assay in patients with severe TBI CXCL1 in brain tissue; brain tissue injury and ELISA assay at different time points The expression of CXCL1 protein in the blood; Spearman correlation analysis on different time points of CXCL1 in peripheral blood and protein content after 30 d Glasgow Outcome Scale (GOS) score were analyzed. Results the normal brain tissue CXCL1 is mainly expressed in astrocytes; severe TBI, CXCL1 mainly expressed in neurons and astrocytes in severe TBI group. CXCL1 protein in brain tissue is higher than in severe TBI group (t=-12.58, P0.05). Severe TBI group CXCL1 protein in blood on the preoperative content reached the peak, then decreased gradually, after 14 d was still higher than that of healthy control group (P0.05), 30 d after the operation to the health level (P0.05). Severe TBI group CXCL1 protein in the blood content of preoperative and postoperative 1 D is the highest, then gradually decreased after 30 d was still higher than that of healthy subjects (P0.05). Preoperative and postoperative 30 d, severe CXCL1 group TBI protein content were higher than severe TBI group (P0.05). Special Severe TBI group preoperative CXCL1 protein content in blood was negatively correlated with the GOS score (r=-0.351, P0.05). Conclusion CXCL1 expression was significantly increased after severe TBI, and mainly expressed in neurons and astrocytes, severity and prognosis and the content of CXCL1 in a certain extent can reflect brain damage.

【作者單位】： 南通大學(xué)附屬醫(yī)院康復(fù)醫(yī)學(xué)科;常州市婦幼保健院;
【基金】：南通大學(xué)博士科研啟動(dòng)基金項(xiàng)目(No.2016-2) 南通市科技計(jì)劃項(xiàng)目(No.MS22016044)
【分類號(hào)】：R651.15

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