论文部分内容阅读
目的探讨进展性脑梗死(SIP)患者外周血循环内皮细胞(CECs)、糖化血红蛋白(Hb A1c)、同型半胱氨酸(Hcy)的含量变化及其临床意义。方法选取2014年11月至2016年4月在石家庄市第一医院神经内科确诊的SIP患者50例(SIP组)、非进展性脑梗死(NSIP)患者50例(NSIP组),并选择同一时期进行体检的正常健康成人24例作为对照组。运用流式细胞仪法测定SIP组及NSIP组发病第1天和第7天外周血中CECs的含量,用Hb A1c分析仪、氨基酸分析仪分别测定脑梗死患者Hb A1c、Hcy含量,并与24例健康对照组进行比较。结果 SIP组及NSIP组发病第1天CECs、Hb A1c明显高于正常对照组(P均<0.05),但3组Hcy水平无显著差异(P均>0.05);SIP组Hb A1c、第7天CECs水平明显高于NSIP组,SIP组和NSIP组发病第7天外周血CECs水平较发病第1天均明显升高(P均<0.05)。SIP组发病第7天外周血CECs水平与Hb A1c(r=0.714,P=0.000)、Hcy(r=0.819,P=0.000)均呈明显正相关,NSIP组发病第7天CECs水平与Hcy呈正相关(r=0.55,P=0.000),与Hb A1c无相关性(r=0.161,P=0.265)。结论血管内皮损伤在脑梗死发病机制中发挥重要作用,Hb A1c、Hcy含量的升高可能是脑梗死急性期病情进展的重要因素。
Objective To investigate the changes of circulating endothelial cells (CECs), Hb A1c and homocysteine (Hcy) in patients with progressive cerebral infarction (SIP) and their clinical significance. Methods Fifty patients with SIP (SIP group) and 50 patients with non-progressing cerebral infarction (NSIP) were enrolled in the Department of Neurology, First Hospital of Shijiazhuang from November 2014 to April 2016. The patients in the same period Twenty-four healthy, healthy adults underwent physical examination as control group. Flow cytometry was used to determine the levels of CECs in the peripheral blood on the first day and the seventh day after onset in the SIP and NSIP groups. Hb A1c and amino acid analyzers were used to determine the levels of Hb A1c and Hcy in patients with cerebral infarction. Cases of healthy control group for comparison. Results The levels of Cys and Hb A1c on day 1 of SIP group and NSIP group were significantly higher than those of normal control group (all P <0.05), but the levels of Hcy in 3 groups were not significantly different (all P> 0.05) The levels of CECs were significantly higher in NSIP group than those in NSIP group. On the 7th day after onset, the levels of CECs in SIP group and NSIP group were significantly higher than those on the first day (P <0.05). The level of CECs in peripheral blood of SIP group was positively correlated with Hb A1c (r = 0.714, P = 0.000) and Hcy (r = 0.819, P = 0.000) on the 7th day. (R = 0.55, P = 0.000), but no correlation with Hb A1c (r = 0.161, P = 0.265). Conclusion Vascular endothelial injury plays an important role in the pathogenesis of cerebral infarction. Elevated levels of Hb A1c and Hcy may be important factors in the progression of acute cerebral infarction.