摘要
目的 研究血清脑源性神经营养因子(BDNF)及胰岛素样生长因子-1(IGF-1)与急性脑梗死患者进展性运动功能缺损(PMD)的关系。方法 选择2017年7月—2019年12月期间成都中医药大学附属医院收治的急性大脑中动脉闭塞(MCAO)患者作为MCAO组,同期体检的健康者作为对照组。MCAO组患者入院后连续5 d留取血清并检测BDNF、IGF-1水平,对照组体检时留取血清并检测BDNF、IGF-1水平。MCAO组患者发病5 d内美国国立卫生研究院卒中量表(NIHSS)中运动项目评分增加≥2分且持续24 h以上判断为PMD。采用Pearson检验分析BDNF、IGF-1与NIHSS评分的相关性,采用Logistic回归模型分析BDNF、IGF-1与PMD的关系。结果 MCAO组患者入院第1天血清BDNF、IGF-1水平低于对照组(P<0.05);入院后第1~5天,MCAO组中PMD患者的血清BDNF、IGF-1水平无明显变化,非PMD患者的血清BDNF、IGF-1水平呈逐渐升高趋势,且高于PMD患者(P<0.05);MCAO组患者血清BDNF、IGF-1水平与NIHSS总评分、NIHSS运动评分呈负相关;入院后第1天的BDNF是发生PMD的影响因素。结论 血清BDNF、IGF-1水平降低与急性脑梗死病情加重及PMD发生有关,其中入院第1天的BDNF水平是发生PMD的相关因素。
Objective To study the relationship between serum brain-derived neurotrophic factor(BDNF),insulin-like growth factor-1(IGF-1)and progressive motor deficits(PMD)of patients with acute cerebral infarction.Methods Patients with acute middle cerebral artery occlusion(MCAO)treated in the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from July 2017 to December 2019 were selected as the MCAO group and healthy persons undergoing physical examination at the same time as the control group.Serum of MCAO group was collected for 5 consecutive days after admission,then BDNF and IGF-1 were detected.Serum of control group was collected when physical examination,then BDNF and IGF-1 were detected.The patients in MCAO group whose NIHSS score increased more than 2 points within 5 days after onset and lasted for more than 24 h were judged as PMD.Pearson test was used to analyze the correlation between BDNF,IGF-1 and NIHSS scores,and Logistic regression model was used to analyze the relationship between BDNF,IGF-1 and PMD.Results The levels of BDNF and IGF-1 in serum of MCAO group were lower than those of the control group(P<0.05).1~5 d after admission,there was no significant change of serum BDNF and IGF-1 levels in PMD patients in MCAO group,and the serum BDNF and IGF-1 levels in non PMD patients gradually increased,and the serum BDNF and IGF-1 levels in PMD patients were lower than those in non PMD patients in MCAO group(P<0.05);Serum BDNF and IGF-1 levels were negatively correlated with NIHSS total score and NIHSS exercise score in MCAO group.BDNF at 1 d after admission was the influencing factor of PMD.Conclusion The decrease of serum BDNF and IGF-1 relates to the aggravation of acute cerebral infarction and occurrence of PMD.The BDNF level on the first day of admission is the related factor of PMD.
作者
龙忽林
郭耀光
王德英
胡怡然
LONG Hulin;GUO Yaoguang;WANG Deying;HU Yiran(Acupuncture Department,Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu Sichuan 610072,China)
出处
《中国急救复苏与灾害医学杂志》
2023年第5期633-636,641,共5页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
四川中药文化协同发展科研项目(编号:2012-D-YY-11)。
关键词
急性脑梗死
急性大脑中动脉闭塞
脑源性神经营养因子
胰岛素样生长因子-1
进展性运动功能缺损
Acute cerebral infarction
Acute middle cerebral artery occlusion
Brain derived neurotrophic factor
Insulin-like growth factor-1
Progressive motor deficits论著临床急诊急救中国急救复苏与灾害医学杂志2023年5月第18卷第5期Chin J Emerg Resusc Disaster Med,May 2023,Vol.18 No.5
