摘要
目的:探讨脑卒中急性期脑脊液中髓磷脂碱性蛋白抗体浓度与神经功能预后,肢体瘫痪程度和病程的关系。方法:选择2002-01/2003-01惠州市中心人民医院神经内科住院的急性脑卒中患者122例,男70例,女52例;年龄28～88岁。有近期神经功能预后记录者共111例,其中死亡9例,病情无变化16例,病情好转(指瘫痪恢复1级)54例,病情明显好转(指瘫痪恢复2级或2级以上)32例。108例患者有不同程度的偏瘫,其中轻度偏瘫34例,重度偏瘫74例。入院时病程在12h以内患者17例,12～24h19例,24～72h20例,4～7d26例,8～15d20例,16d以上20例。同期选择以无神经系统器质损害的功能性头痛患者38例和无神经系统疾病患者104例的脑脊液作为对照组,共142例。均知情同意。所有被检患者在发病后病情许可的情况下,采脑脊液1mL,根据酶联免疫吸附间接法测定髓磷脂碱性蛋白抗体(微量法)。其中23例患者分别于发病后的第2周或第3周时复查髓磷脂碱性蛋白抗体,评估脑白质神经元受损情况。结果:参加试验的122例急性脑卒中和142例对照组患者,全部进入结果分析。①122例急性脑卒中患者中有101例脑脊液髓磷脂碱性蛋白抗体阳性,142例对照组中有1例患者脑脊液髓磷脂碱性蛋白抗体可疑阳性,脑卒中组脑脊液髓磷脂碱性蛋白抗体吸光度明显高于对照组(4.90±5.35,0.24±0.35,t=8.45,P<0.001)。②74例重度偏瘫患者的脑脊液髓磷脂碱性蛋白抗体吸光度值高于34例轻度偏瘫患者(5.46±5.71,3.10±3.67,t=2.21,P<0.05)。③122例中有短期神经功能预后记录者111例,病情无变化患者脑脊液髓磷脂碱性蛋白抗体吸光度明显高于病情好转和病情明显好转患者(9.20±4.38,4.21±4.95,1.74±1.95,F=10.02,P<0.01)。④病程在12h以内,12～24h,24～72h,4～7d,8～15d,16d以上者的脑脊液髓磷脂碱性蛋白抗体吸光度分别为7.20±8.33,5.63±5.59,4.44±5.28,4.31±4.25,3.77±3.79,3.06±3.01。随着病
AIM:To study the association of neural functional prognosis,degree of extremity hemiplegia,and course of disease with concentration of myelin basic protein antibody in cerebrospinal fluid in patients with acute stroke.METHODS:A total of 122 patients with acute stroke(male:70 cases;female:52 cases) with 28-88 years of age were selected from the Department of Neurology,Central People's Hospital of Huizhou from January 2002 to January 2003.Totally 111 cases showed neural functional prognosis in the near future,among whom,9 died;16 showed no changes of patient's condition; 54 showed improved patient's condition(recovery of hemiplegia: 1 grade);32 showed significantly improved patient's condition(recovery of hemiplegia:2 grade or over).Totally 108 patients showed different degree of hemiplegia;among them,34 cases were mild and moderate hemiplegia,74 were severe hemiplegia.The course of disease was within 12,12-24,24-72 hours,4-7,8-15 and 16 days in 17,19,20,26,20 and 20 patients,respectively.And 38 patients with functional headache without nervous system injury and 104 patients without nervous system injury were selected as controls.1 mL cerebrospinal fluid sample was obtained from each patient as soon as patient's condition was permitted to detect the level of myelin basic protein antibody by using enzyme linked immunosorbent assay.The myelin basic protein antibody of 23 patients was reexamined at week 2 or 3 after onset to evaluate the injury of neurons in brain protein.RESULTS:All 122 acute stroke patients and 142 controls were involved in the result analysis.①Myelin basic protein antibody in cerebrospinal fluid in 101 of 122 acute stroke patients indicated positive expression, and 1 of 142 in control group was suspectious of positive expression.The absorbency of myelin basic protein antibody in acute stroke patients was obviously higher as compared with that in controls(4.90±5.35,0.24±0.35,t=8.45,P< 0.001). ②The absorbency of myelin basic protein antibody in 74 severity hemiplegia was higher than that in
出处
《中国临床康复》
CSCD
北大核心
2005年第21期104-105,共2页
Chinese Journal of Clinical Rehabilitation
