急性脑梗死不同临床亚型患者血清髓鞘碱性蛋白的变化

The clinical study on changes of myelin basic protein in different subtype of acute cerebral infarction patients

目的观察不同临床类型急性脑梗死（ACI）患者血清髓鞘碱性蛋白（MBP）水平变化，探讨MBP与美国国立卫生研究所卒中量表（NIHss）评分之间的关系。方法208例AcI患者按照牛津郡社区卒中计划（OCSP）分型标准分为4组并行NIHSs评分，采用ELISA法检测血清MBP的含量；观察不同亚型ACI患者MBP含量的变化，分析MBP与NIHSS评分的相关性。结果（1）本组OCSP各亚型构成比：完全前循环型（TACI）13．46％、部分前循环型（PACI）30．29％、后循环型（POCI）19．71％、腔隙性梗死型（LACI）36．54％；（2）OCSP分型中TACI、PACI及POCI亚型MBP含量升高，LACI变化不明显。与LACI比较，TACI、PACI及POCI有显著性差异（P〈0．05）；（3）TACI、PACI中血清MBP含量与相应时间段NIHSS评分具有有相关性，相关系数为0．62、0．60（P〈0．05）；POCI和LACI中MBP与NIHSS之间相关性较差。结论MBP随0CSP亚型的不同而变化。TACI、PACI、POCI亚型的缺血性卒中患者血清MBP可以作为病情、预后判断的一个参考依据。

Objective To investigate the serum level of myelin basic protein （MBP） and its rela tionship with the scores measured by American National Institutes of Health stroke scale（NIHSS） in different subtypes of acute cerebral infarction（ACI） patients. Methods 208 ACI Patients were classified into 4 groups based on the criteria of the Oxfordshire Community Stroke Project（OCSP）. All patients were scored according to the NIHSS and their serum MBP were determined by the method of ELISA. Results （1）The percentage of each ischemic stroke OCSP subtype was as follow：total anterior circulation infarcts 13.46%, partial anterior circulation infarcts 30. 29% ,posterior circulation infarcts 19.71 %, lacunar infarcts 36. 54%. （2）The serum level of MBP in TACI,PACI and POCI was increased after cere bral infarction. The serum level of MBP of LACI had no significant change in OCSP. Compared to the I.ACI group,the serum level of MBP of TACI,PACI and POCI were significantly different （P 〈 0.05）. （3）There was a positive correlation in TACI and PACI groups （r = 0.62.0.60,P〈0.05） and there was a negative correlation in POCI and I.ACI groups. Conclusions Different classification group had different serum level of MBP. There was a positive correlation between MBP and NIHSS score in some subtypes. The serum level of MBP was associated with the severity of cerebral infarction.