CD36促进脑出血患者血肿吸收及其临床意义

CD36 promotes hematoma absorption in patients with intracerebral hemorrhage and its clinical significance

目的探讨CD36对脑出血患者血肿吸收及神经功能缺损的影响。方法选择2012年7月至2014年6月在第三军医大学新桥医院神经内科住院治疗的349例脑出血患者为研究对象,获得患者静脉全血后进行CD36突变筛查,在突变的35例患者中挑选出24例为基底节区出血的患者分入CD36缺陷组,同时在CD36正常的患者中挑选出24例基线水平一致的基底节区出血患者(CD36正常组),比较2组患者的血肿吸收、炎症变化及神经功能缺损评分。结果 349例脑出血患者中筛选出35例CD36缺陷患者(10.03%)。2组患者的年龄、性别、入院时血肿体积、危险因素等基线水平差异无显著性(P>0.05)。发病7 d后CD36缺陷患者血肿吸收速率低于CD36正常患者[(22.4±2.4)%vs(44.8±5.1)%,P<0.05],并且CD36缺陷患者炎症因子下降较CD36正常患者慢(P<0.05)。神经功能缺损评分显示CD36缺陷患者在第14、30、90天时显著高于CD36正常患者(P<0.05)。结论CD36可能在促进血肿吸收中具有重要作用进而影响患者的神经功能恢复。

Objective To investigate the influence of CD36 in hematoma absorption and neurologic deficit scores（ NDS） in the patients with intracerebral hemorrhage（ ICH）. Methods A total of 349 ICH patients treated in our department from July 2012 to June 2014 were selected as the research objects. Among them,24 ICH patients with cerebral basilar hemorrhage were selected from 35 patients with CD36 mutation,and divided into CD36-deficiency group. Meanwhile,24 CD36-normal ICH patients who had similar features with the CD36-deficency group were selected as the CD36-normal group. The hematoma absorption,inflammatory responses and NDS of the 2 groups were compared. Results Thirty-five patients（ 10. 03%）with CD36 deficiency were screened from the 349 ICH patients. There were no significant differences in the age,gender,hematoma volume on admission,risk factors,and other baseline data between the 2 groups（ P〉0. 05）. On day 7 after ICH,the hematoma absorption of CD36-deficiency patients was significantly lower than that of CD36-normal patients（ 22. 4% ± 2. 4% vs 44. 8% ± 5. 1%,P〈0. 05）,as well as the reduction rate of pro-inflammatory factors on day 14 after ICH（ P〈0. 05）. Moreover,on the days 14,30 and 90 after ICH,the NDS of CD36-deficiency patients were higher than those of CD36-normal patients（ P〈0. 05）.Conclusion CD36 may play an important role in promoting the hematoma absorption and improving the NDS after ICH.