急性脑梗死患者治疗前后GMP-140、PAF变化的临床研究

Clinical research on the changes of GMP-140 and PAF before and after treatment in patients with acute cerebral infarction

目的 探讨急性脑梗死患者治疗前后血浆血小板膜蛋白-140（GMP-140）、血小板活化因子（PAF）的水平变化及临床意义,从而为临床的治疗提供理论依据。方法 选择2013年1—12月衢州市人民医院收治的发病在6-24 h内的脑梗死住院患者30例,另选健康成人30例作为对照组。所有脑梗死患者入院后均进行拜阿司匹林肠溶片200 mg抗血小板聚集,控制血糖、血脂,调整血压并酌情使用神经营养和脱水剂等治疗,疗程为14 d。采用酶联免疫吸附试验测定2组患者（治疗前后）血浆GMP-140、PAF水平,通过SPSS 13.0统计软件进行统计学处理比较它们之间的差异。结果 急性脑梗死患者治疗前血浆GMP-140和PAF水平分别为（34.53±5.38）ng/ml和（110.20±16.67）ng/ml,健康成人血浆GMP-140和PAF水平分别为（12.23±2.43）ng/ml和（64.27±16.60）ng/ml,急性脑梗死患者治疗前外周血GMP-140、PAF浓度较对照组比较明显升高,差异具有统计学意义（P〈0.01）;急性脑梗死患者治疗后血浆GMP-140和PAF水平分别为（21.17±3.91）ng/ml和（59.67±7.52）ng/ml,与治疗前相比其浓度水平显著下降,差异均具有统计学意义（P〈0.01）。结论 检测血浆GMP-140和PAF水平,对监测血小板功能和活化状态相关的临床状态有重要的参考意义,可以用于对治疗的有效性进行评价,判断及评估预后。

Objective To study the clinical significance of difference of platelet GMP-140 and platelet-activating factor level after treatment from those before treatment in patients with acute cerebral infarction. Methods To select hospitalized patients in People＇ s Hospital of Quzhou City between 2013 January and 2013 December as the study object. 30 patients with infarction of the cerebral median artery whose onset duration were between 6 -24 hours as observation group, and 30 healthy adults cases as a control group. All the patients with cerebral infarction after admission were worshipped Aspirin Enteric-coated Tablets 200 mg platelet aggregation, control of blood glucose, blood lipid, blood pressure and adjust as appropriate use of neurotrophic and dehydrating agent treatment, 14 clays for a course. Linked immunosorbent assay was used for determination of platelet GMP-140 and platelet-activating factor level after treatment and those before treatment. The difference between them was compared through the SPSS 13.0 statistical software. Results Before treatment, GMP- 140 and PAF levels of patients with acute cerebral infarction were （34.53 ± 5.38）ng/ml and （110.20 ＋ 16.67）ng/ml. GMP-140 and PAF levels of healthy adult were （ 12.23 ± 2.43 ） ng/ml and （ 64.27± 16.60） ng/ml. Before treatment, peripheral blood GMP-140, PAF concentration in patients with acute cerebral infarction was increased significantly compared to the control group（ P 〈 0.0l ）. After treatment,the plasma GMP-140 and PAF levels of patients with acute cerebral in- farcfion were （21.17 ± 3.91 ）ng/ml and （59.67 ± 7.52 ）ng/ml. Compared with patients before treatment, the concentration levels decreased significantly, the difference was statistically significant（ P 〈 0.01 ）. Conclusion Acute cerebral infarction characterized as severe illness, poor prognosis, effective treatment can change its prognosis. Detection of plasma GMP-140 and PAF levels had important reference significance and can be used to evaluate the effect of treatment of the judgment and evaluation of prognosis.