急性脑血管病患者血浆血栓素B_2和6-酮-前列环素的动态分析

The dynamic analysis of the level of plasma TXB2 and 6-keto-PGF1α in acute cerebrovascular disease

目的动态测定急性脑血管病患者血浆中的血栓素B2(TXB2)、6-酮-前列环素(6-keto-PGF1α)及TXB2/6-keto-PGF1α(T/6-K)比值,为临床积极干预提供参考依据。方法急性脑血管病患者300例,分为3组:CI组205例、TIA组70例、CH组25例,正常对照组120例。ELISA双抗体夹心法测定TXB2,ELISA竞争抑制法测定6-keto-PGF1α。测定急性脑血管病患者发病24h内、1周时、2周时的血浆TXB2、6-酮-前列环素1α及TXB2/6-K比值,同时将其动态值变化与正常对照组进行统计分析。结果 3组患者发病24h内、1周时、2周时的血浆TXB2、6-keto-PGF1α的含量均高于正常对照组(P<0.01),TXB2到一周时最高,到二周时下降,6-keto-PGF1α逐渐增高,到2周时最高。3组患者TXB2/6-K在发病24h内、1周时均高于正常对照组(P<0.01),1周时最高,CI组,TIA组到2周时下降基本和正常对照组相似(P>0.05),CH组下降比正常对照组低(P<0.01)。结论维持TXB2/6-keto-PGF1α的平衡有助于血流通畅,TXB2、6-keto-PGF1α水平可反映急性脑血管患者血小板活化功能状态和血管内皮细胞损伤情况。临床常规测定有助于急性脑血管病事件的综合评估。对于TIA患者患者进一步发展为脑梗死有重要的警示价值。

Objective To provide reference evident for active clinical intervention,we assessed the dynamic changes of the level of plasma TXB2,6-keto-PGF1α,and the ratio of TXB2/6-keto-PGF1α in acute cerebrovascular disease.Methods We divided the total amount of 300 patients with acute cerebrovascular disease into three groups,as 205 patients with cerebral ischemic stroke,70 patients with TIA and 25 patients with cerebral hemorrhagic stroke.At the same time,120 people were chosen as the controls.Using the double antibody sandwich ELISA method to measure TXB2 and competitive inhibition ELISA method to measure 6-keto-PGF1α,we assessed the level of plasma TXB2,6-keto-PGF1α,and the ratio of TXB2/6-keto-PGF1α within 24 hours,one week and two weeks after the onset of clinical event respectively.After that,we compared the dynamic changes of the above parameters of targeted group with those of the normal control group statically.Results The plasma levels of TXB2 and 6-keto-PGF1α in the above three groups were higher than that of the control group within 24 hours,one week and two weeks after the onset of clinical event,respectively.The level of TXB2 reached the summit at one week and decreased gradually at two weeks;however,6-keto-PGF1α level increased gradually and its peak occurred at two weeks after the onset of clinical event.The ratio of TXB2/6-keto-PGF1α in the above three groups was higher than that of the control group at the time of within 24 hours and one week（P〈0.01） after the onset of clinical event,respectively,with the time point of one week most evident.Nevertheless,the ratio of the CI group and TIA group was approximately similar to the control group at two weeks,in the contrast,the ratio of CH group was lower than that of the control group at two weeks.Conclusion To maintain the balance of TXB2/6-keto-PGF1α is very useful to the blood flow.The plasma level of TXB2、6-keto-PGF1α can reflect the state of platelet reactivity and impairment of vascular endothelia cells in patients with acute cerebrovascular disease.Routine clinical measurement benefits the comprehensive assessment for the acute cerebrovacular patients,as well as provides a warning value for the TIA patients to aggravate cerebral ischemic stoke.Whether aspirin can alleviate the cerebral damage and promote the recovery of the patients with acute cerebral hemorrhagic stroke,we need further investigate through increasing the sample size.