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目的探讨急性缺血性脑血管病(ICVD)发病及进展程度与血清ET、BG、Cr及UN水平的关系,以期为ICVD发病机制和临床诊治提供理论依据。方法选取本院2011年-2012年间收治的急性ICVD患者79例(研究组),取空腹静脉血,测定血清ET、BG、Cr及UN水平;并与同期入院体检的健康志愿者61例(对照组)做对比分析,确定敏感指标。按神经功能缺损评分将79例急性ICVD患者分为轻度缺损21例(TCⅠ组),中度缺损33例(MCⅠ组),及重度缺损25例(SCⅠ组);比较各敏感指标的组间差异。结果敏感指标的确定:研究组患者ET及BG两项指标的水平显著高于对照组(P<0.05);Cr稍高于对照组,UN稍低于对照组,但差异均无统计学意义(P>0.05);以ET、BG为急性ICVD的敏感指标。敏感指标的比较:MCⅠ组患者ET及BG水平显著高于TCⅠ组(P<0.05);SCⅠ组患者ET及BG水平显著高于MCⅠ组(P<0.05);随着神经功能缺损的加重,其ET及BG水平均呈显著上升趋势。结论 ET与BG两项指标与急性ICVD的发病和进展密切相关,可作为急性ICVD的敏感因子进行实时监测;同时,也可从抗ET与降BG入手,摸索急性ICVD的治疗策略。
Objective To investigate the relationship between the incidence and progression of acute ischemic cerebrovascular disease (ICVD) and the levels of serum ET, BG, Cr and UN in order to provide a theoretical basis for the pathogenesis and clinical diagnosis and treatment of ICVD. Methods A total of 79 acute ICVD patients (study group) admitted to our hospital from 2011 to 2012 were enrolled in this study. Fasting venous blood was collected for determination of serum ET, BG, Cr and UN levels. Sixty-one healthy volunteers Group) to do comparative analysis to determine the sensitive indicators. According to the neurological deficit score, 79 patients with acute ICVD were divided into mild defect (TCⅠgroup), moderate defect (MCⅠgroup) and severe defect (SCⅠgroup) difference. The results of sensitive indicators to determine: the study group of patients ET and BG two indicators was significantly higher than the control group (P <0.05); Cr slightly higher than the control group, UN slightly lower than the control group, but the difference was not statistically significant P> 0.05); with ET, BG as a sensitive indicator of acute ICVD. The levels of ET and BG in patients with MCI were significantly higher than those in patients with TCⅠ (P <0.05). The levels of ET and BG in patients with SCⅠwere significantly higher than those in patients with MCⅠ (P <0.05). With the increase of neurological deficit, ET and BG levels showed a significant upward trend. Conclusions The two indexes of ET and BG are closely related to the onset and progression of acute ICVD and can be used as real-time monitoring for the sensitive factors of acute ICVD. Meanwhile, the treatment strategies of acute ICVD can also be explored from anti-ET and BG-lowering.