失眠合并脑梗死患者血浆GABA、Glu、Ach水平的临床研究

Clinical Study of Plasma GABA,Glu and Ach Levels in Patients with Insomnia Combined with Cerebral Infarction

目的:探讨失眠合并脑梗死患者血浆氨基丁酸(GABA)、谷氨酸(Glu)、乙酰胆碱(Ach)水平变化及临床意义。方法:选取2017年1-12月本院门诊和住院的脑梗死患者90例作为研究对象,按有无合并失眠将其分为失眠合并脑梗死(IS)组(n=30)、脑梗死无失眠(S)组(n=30)和失眠(I)组(n=30);另于体检中心选取同期健康人群30例作为正常对照组。采用高效液相色谱法测定各组血浆GABA、Glu、Ach水平,对IS组的NIHSS评分与GABA、Glu、Ach生化指标的相关性进行分析。结果:各组间血浆GABA、Glu、Ach水平比较,差异均有统计学意义(P<0.05)。IS、S和I组血浆GABA、Glu、Ach水平较正常对照组均明显降低,IS和S组较I组均明显降低,IS组较S组均明显降低,差异均有统计学意义(P<0.05)。IS组的NIHSS评分与Ach水平(r=-0.332,P=0.013)、Glu水平(r=-0.353,P=0.007)和GABA水平(r=-0.446,P=0.002)均呈负相关。结论:GABA、Glu和Ach参与了脑梗死后失眠的病理生理过程,血浆GABA、Glu和Ach水平的变化可在一定程度上反映患者失眠的严重程度。

Objective:To investigate the changes of plasma aminobutyric acid(GABA),glutamic acid(Glu)and acetylcholine(Ach)levels in patients with insomnia combined with cerebral infarction and its clinical significance.Method:A total of 90 patients with cerebral infarction in outpatient and inpatient of our hospital from January to December 2017 were selected as the research objects.According to whether there was insomnia,they were divided into three groups:insomnia combined with cerebral infarction(IS)group(n=30),cerebral infarction without insomnia (S) group (n=30)and insomnia (I) group (n=30).30 healthy people in the physical examination center at the same period were selected as the normal control group.The levels of plasma GABA,Glu and Ach were determined by high performance liquid chromatography.The correlation between NIHSS score in IS group and biochemical indexes of GABA,Glu and Ach were analyzed.Result:There were significant differences in plasma GABA,Glu and Ach levels among the groups(P<0.05).The levels of plasma GABA,Glu and Ach in IS group,S group and I group were significantly lower than those in the normal control group,IS group and S group were significantly lower than those in I group,and IS group were significantly lower than those in S group,the differences were statistically significant(P<0.05).NIHSS score in IS group was negatively correlated with Ach level(r=-0.332,P=0.013),Glu level(r=-0.353,P=0.007)and GABA level(r=-0.446,P=0.002).Conclusion:GABA,Glu and Ach are involved in the pathophysiological process of insomnia after cerebral infarction.The changes of plasma GABA,Glu and Ach levels can reflect the severity of insomnia to some extent.