血清胆红素和P选择素在老年脑梗死患者中的动态变化及意义

Dynamic change of bilirubin and P-selectin in elderly ischemic stroke patients and its clinical significance

目的探讨急性老年脑梗死患者血清P选择素和胆红素在不同时间、不同病情的动态变化及其临床意义。方法选择脑梗死患者98例(脑梗死组),据据神经功能缺损程度分为轻型38例、中型35例、重型25例,另选取健康体检者30例为对照组,测定脑梗死组患者发病1、3、7、14d和对照组血清可溶性P选择素和胆红素及高敏C反应蛋白水平的动态变化。结果脑梗死组1、3、7dP选择素、高敏C反应蛋白、总胆红素和间接胆红素明显高于对照组,差异有统计学意义(P<0.05)。与脑梗死轻型患者比较,中型和重型患者1、3、7dP选择素显著升高[(78.2±15.0)ng/L,(107.1±24.3)ng/L,(91.5±21.1)ng/L和(85.5±18.5)ng/L,(135.2±34.0)ng/L,(99.3±27.0)ng/L vs(48.8±6.7)ng/L,(86.0±10.9)ng/L,(72.5±11.3)ng/L,P<0.05]。结论 P选择素和胆红素可能参与脑梗死的病理过程,测定P选择素和胆红素有利于脑梗死的早期诊治及判断预后。

Objective To study the dynamic change of bilirubin and P-selectin in elderly acute ischemic stroke（AIS）patients at different time points and at different conditions of disease and its clinical significance.Methods Ninety-eight ischemic stroke（IS）patients were divided into mild IS group（n=38）,moderate IS group（n=35）and severe IS group（n=25）according to their nerve function score,and 30 healthy subjects undergoing physical examination served as a control group.Their serum levels of P-selectin,bilirubin and hs-CRP were measured on days 1,3,7and 14 respectively after onset of IS.Results The serum levels of P-selectin,hs-CRP,total and indirect bilirubin were significantly higher in different IS groups than in control group,in moderate and severe IS groups than in mild IS group on days 1,3,7after onset of IS（P〈0.05）.The serum P-selectin level was significantly higher in moderate and severe IS groups than in control group on day14 after onset of IS（78.2±15.0ng/L,107.1±24.3ng/L,91.5±21.1ng/L,85.5±18.5ng/L,135.2±34.0ng/L,99.3±27.0ng/L vs 48.8±6.7ng/L,86.0±10.9ng/L,72.5±11.3ng/L,P〈0.05）.Conclusion P-selectin and bilirubin may be involved in the pathogenesis of IS.Measurement of serum P-selectin and bilirubin level contributes to the early diagnosis and treatment of IS and assessment of its prognosis.