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目的探讨缺血性进展性脑卒中(PIS)患者下丘脑-垂体-肾上腺(HPA)轴分泌的促肾上腺皮质激素(ACTH)、皮质醇(COR)的变化及与甲状旁腺激素(PTH)的相关性。方法选择东风总医院PIS患者41例为观察组,44例非进展性脑卒中患者为对照组。比较两组患者血浆ACTH、血清COR、血清PTH及血浆超敏C反应蛋白(hs-CRP)的浓度并分析相关性。结果观察组患者不同时间点(8:00、16:00、24:00)血浆ACTH、血清COR浓度高于对照组,且日平均ACTH、日平均COR、血清PTH及血浆hs-CRP浓度亦高于对照组,差异有统计学意义(P<0.05)。相关分析显示,观察组患者日平均ACTH、日平均COR与血清PTH呈正相关(r=0.30、0.42,P<0.05或P<0.01)。结论 PIS患者HPA轴功能紊乱且血清PTH分泌增多,两者相互作用,可共同作为诊断PIS重要的临床参考指标。
Objective To investigate the changes of adrenocorticotropic hormone (ACTH) and cortisol (COR) secreted by the hypothalamus - pituitary - adrenal (HPA) axis in patients with ischemic progressive stroke (PIS) and their relationship with parathyroid hormone Correlation. Methods 41 patients with PIS in Dongfeng General Hospital were selected as observation group and 44 patients with non-progressive stroke as control group. Plasma ACTH, serum COR, serum PTH and plasma hs-CRP concentrations were compared between the two groups and the correlation was analyzed. Results The plasma ACTH and serum COR concentrations in observation group were higher than those in control group at different time points (8: 00,16: 00,24: 00), and mean daily ACTH, daily average COR, serum PTH and plasma hs-CRP were also high In the control group, the difference was statistically significant (P <0.05). Correlation analysis showed that daily mean ACTH, daily average COR and serum PTH in the observation group were positively correlated (r = 0.30,0.42, P <0.05 or P <0.01). Conclusions HPA axis dysfunction and increased serum PTH secretion in PIS patients may interact with each other and may serve as an important clinical reference for diagnosis of PIS.