脑卒中急性期血浆淀粉样β蛋白水平与血管性痴呆的关系(英文)

Relationship between amyloid beta protein level and vascular dementia in acute cerebral apoplexy

背景:淀粉样β蛋白(amyloidbetaprotein,Aβ)是阿尔茨海默病(Alzheimerdisease,AD老年斑的重要组成成分之一,它在脑内的沉积被)认为是AD发病机制的关键步骤,动物试验提示Aβ也参与了血管性痴呆(vasculardementia,VD)的发病过程。但在临床试验中Aβ含量变化是否与VD的发病有关还不清楚。目的:测定脑卒中患者急性期和VD患者血浆Aβ的含量,探讨其在VD发病机制中的作用。设计:病例对照研究。单位:重庆医科大学附属第一医院神经内科和核医学科。对象:2001-09/2002-12重庆医科大学附属第一医院神经内科住院脑卒中急性期患者92例(脑卒中组),脑出血28例,脑梗死64例;病灶在右侧大脑半球的30例,在左侧大脑半球的29例,另33例左右半球均有病灶或病灶在脑干、小脑;病情轻者71例,病情较重者9例,病情重者12例。同期门诊或住院血管性痴呆患者62例(血管性痴呆组)。正常对照组来自重庆市主城区健康志愿者45例。方法:采用平衡饱和竞争放射免疫方法测定正常对照组、脑卒中急性期患者、VD患者血浆中Aβ的浓度,比较各组有无显著性差异,分析不同病因、病变部位、病情严重程度对Aβ的含量的影响。主要观察指标:各组患者血浆中Aβ的含量。脑卒中急性期患者中不同病因、病变部位、病情严重程度的各组患者Aβ的含量。结果:脑卒中患?

BACKGROUND: Amyloid βprotein(Aβ) is one of the components of senile plaque o f Alzheimer Disease(AD).It is believed that deposit of it is the key step of dev elopment of AD.Animal experiment has indicated that Aβalso participates the occ urrence of VD.However,it is uncertain that if the content change of Aβis relate d to the cause of VD. OBJECTIVE:To assay the content of Aβin plasma in patients with acute cerebral apoplexy and VD to explore its effects in pathological mechanism of VD. DESIGN:Case control study. SETTING:Neurological Department and Nuclear Medicine Department of First Affil iated Hospital of Chongqing Medical University. MATERIALS:A total of 92 patients of acute cerebral apoplexy(28 with cerebral h emorrhage and 64 with cerebral infarction) treated in Neurological Department of First Affiliated Hospital of Chongqing Medical University during September 2001 to December 2002 were chosen as cerebral apoplexy group.There were 30 patients had focus in right hemisphere while 29 patients had focus in left hemisphere. Th e other 33 patients had focus in both hemispheres or in brain stem or cerebellum .Totally 71 patients were in mild state while 9 patients of moderate state and 1 2 patients were severe. Sixty tow patients with vascular dementia during the sa me period were selected as VD group.And 45 healthy volunteers were used as contr ol group. METHODS:To detect the Aβconcentration in normal group,patients of acute cereb ral apoplexy and VD patients by using balanced saturated competitive radioimmuno assay,to compare if there is difference between groups and to analyze the effect s of different causes, different areas and severity of disease to the level of A β. MAIN OUTCOME MEASURES:Content of Aβin patients of each group.Aβcontent in pa tients of acute cerebral apoplexy with different causes, area and severity. RESULTS:The Aβlevel in plasma in cerebral apoplexy group, vascular dementia g roup and normal control group was (1.65±0.15) μg/L,(1.04±0.13) μg/L and(4.12 ±0.11) μg/ L respectively.It was much lower in cerebral apoplexy group than th at in normal group(P< 0.05) while comparing with cerebral apoplexy group and con trol group,Aβin VD group was much lower(P< 0.05).There was no significant diffe rence on it between cerebral hemorrhage group and cerebral infarction group and no difference between patients with lesions in different areas.It also has no co rrelation with the severity of disease. CONCLUSION:Aβplays a certain role on the pathological mechanism of VD.