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目的观察不同类型急性脑梗死(ACI)患者血清髓鞘碱性蛋白(MBP)水平变化及其与预后的关系。方法采用ELISA法检测384例连续收住入院、发病在3 d内的ACI患者血清MBP水平,并按照急性卒中治疗低分子肝素试验(TOAST)分型标准分为5大亚型,分析TOAST各亚型MBP水平变化及其与改良Rankin评分(mRS)的相关性。结果TOAST各亚型构成比依次为大动脉粥样硬化型(LAA)35.16%、小动脉闭塞型(SAO)21.09%、心源性栓塞型(CE)17.19%、其他明确病因型(SDE)16.41%、不明原因型(SUE)10.15%。CE、LAA、SUE亚型MBP水平较对照组升高、SAO亚型变化不明显。与对照组比较,LAA、CE亚型MBP水平差异具有统计学意义(P<0.01)。LAA、CE预后不良率高,SAO、SUE预后良好率高。结论 MBP随TOAST亚型不同而异,发病后血清MBP可以作为急性脑梗死患者预后判断的指标之一。
Objective To investigate the changes of serum MBP level in patients with different types of acute cerebral infarction (ACI) and its relationship with prognosis. Methods Serum MBP levels of 384 consecutive ACI patients admitted to hospital within 3 days were detected by ELISA and divided into five major subtypes according to TOAST classification criteria for acute stroke. MBP level changes and its correlation with modified Rankin score (mRS). Results The proportions of TOAST subtypes were 35.16% for major atherosclerosis type (LAA), 21.09% for small artery occlusion type (SAO), 17.19% for cardioembolism type (CE) and 16.41% for other definite etiology (SDE) , Unexplained (SUE) 10.15%. CE, LAA, SUE MBP levels increased compared with the control group, SAO subtypes did not change significantly. Compared with the control group, the levels of LAA and CE subtypes MBP had statistical significance (P <0.01). LAA, CE poor prognosis, high SAO, SUE good prognosis. Conclusions MBP varies with TOAST subtypes. Serum MBP can be used as one of the prognostic indicators in patients with acute cerebral infarction.