ACI患者血清EPO CRP水平的变化

The changes of the concentration of serum EPO and CRP of the ACI patients

目的观察内源性促红细胞生成素(erythropoietin,EPO)、C-反应蛋白(CRP)在急性脑梗死(acute cerebral infarction,ACI)中水平的变化,探讨EPO可能存在的神经保护作用及机。制方法 ACI患者64例,根据头颅CT或MRI梗死灶横断面最大直径分为小梗死灶组、中梗死灶组、大梗死灶组,与正常对照组35例作对照分析。采用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)双抗体夹心法测定血清EPO水平;采用免疫比浊法测定血清C-反应蛋白(C-reactive Protein,CRP)水平。结果脑梗死组血清EPO及CRP水平均高于正常对照组(P<0.01);EPO与CRP水平经直线相关分析呈负相关(r=-0.643,P<0.01);小梗死灶组血清EPO水平高于中、大梗死灶组(P均<0.01),中梗死灶组血清EPO水平高于大梗死灶组(P<0.05);大梗死灶组血清CRP水平高于小、中梗死灶组(P<0.01),小梗死灶组与中梗死灶组血清CRP水平比较差异无显著性(P>0.05)。随着梗死灶的增大,血清EPO水平有逐渐降低的趋势,血清CRP水平有逐渐升高的趋势。结论内源性EPO在ACI中可能存在着一定的神经保护作用,机制之一可能是减轻脑缺血区的炎症反应。外源性EPO有望成为ACI一种新的治疗选择。

Objective To investigate the probable existence of neuroprotective effects and mechanism of endogenous EPO in the ACI and to provide evidences of the probability of the clinical application of EPO for curing ACI.Methods To select 64 cases of patients with acute cerebral infarction 35 cases of normal control group.The serum concentration of EPO was measured by ELISA and the serum concentration of CRP was measured by immuoturbidimetry.Results The concentrations of serum EPO、IL-6 and CRP of cerebral infarction group（CI）were higher than those of normal control group（P0.01）;According to the analysis of the bivariate correlation,there were negative correlations between EPO and CRP（r=-0.643,P0.01）;The serum concentrations of EPO of the small CI were higher than those of the medium or the large one（P0.01）,and the serum concentrations of EPO of the medium CI were higher than those of the large one（P0.05）.The more larger the cerebral infarction size became,the more lower the concentrations of serum EPO became,while the more higher the serum concentrations of CRP became.Conclusion EPO probably has some certain neuroprotective effects in the ACI.One mechanism may be to reduce the inflammatory response in cerebral ischemia.Exogenous EPO is expected to become a new treatment option.