血清S100B、HIF-1α、NGB、AQP7在缺血性脑卒中患者中的表达

Expression of Serum S100B,HIF-1α,NGB and AQP7 in Patients with Ischemic Stroke

目的探讨血清S100B、缺氧诱导因子1α(HIF-1α)、脑红蛋白(NGB)、水通道蛋白7(AQP7)在缺血性脑卒中患者中的表达.方法选择缺血性脑卒中患者366例,根据脑梗死体积分为小体积梗死组(<5 cm^(3))198例,中大体积梗死组(≥5 cm^(3))168例;根据静脉溶栓后24 h复查CT结果分为出血转化组82例,非出血转化组284例;静脉溶栓治疗前进行美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分,根据评分结果分为NIHSS评分≤15分组301例,NIHSS评分>15分组65例.记录患者的空腹血糖、收缩压、舒张压、溶栓时间窗;同时采集患者外周静脉血4 mL,应用Western blot法检测血清S100B、HIF-1α、NGB、AQP7蛋白表达水平.结果中大体积梗死组患者NIHSS评分、收缩压、舒张压明显高于小体积梗死组,差异具有统计学意义(P<0.01);空腹血糖、溶栓时间窗在小体积梗死组与中大体积梗死组之间比较差异无统计学意义(P>0.05).出血转化组患者NIHSS评分、空腹血糖、收缩压、舒张压、溶栓时间窗明显高于非出血转化组,差异具有统计学意义(P<0.01).中大体积梗死组患者血清S100B、HIF-1α、NGB、AQP7蛋白表达水平明显高于小体积梗死组,差异具有统计学意义(P<0.01).出血转化组患者血清S100B、HIF-1α、NGB、AQP7蛋白表达水平明显高于非出血转化组,差异具有统计学意义(P<0.01).NIHSS评分>15分组患者血清S100B、HIF-1α、NGB、AQP7蛋白表达水平明显高于NIHSS评分≤15分组,差异具有统计学意义(P<0.01).结论血清S100B、HIF-1α、NGB、AQP7水平升高参与缺血性脑卒中患者梗死体积的扩大、静脉溶栓后出血转化、NIHSS评分升高,可用于对患者病情严重程度和静脉溶栓潜在出血风险的评估.

Objective To investigate the expression of S100B,HIF-1α,NGB and AQP7 in patients with ischemic stroke.MethodA total of 366 patients with ischemic stroke were selected and divided into small infarction group(<5 cm^(3))198 cases and medium and large infarction group(≥5 cm^(3))168 cases according to the volume of cerebral infarction;According to CT results 24 hours after intravenous thrombolysis,they were divided into bleeding transformation group 82 cases and non bleeding transformation group 284 cases.Before intravenous thrombolysis,the National Institutes of Health Stroke Scale(NIHSS)score was performed.According to the score results,301 cases were divided into NIHSS score≤15 group and 65 cases NIHSS score>15 group.Fasting blood glucose,systolic blood pressure,diastolic blood pressure and thrombolytic time window were recorded;At the same time,peripheral venous blood 4 mL was collected,and the protein expression levels of serum S100B,HIF-1α,NGB and AQP7 were detected by Western blot.ResultsThe NIHSS score,systolic blood pressure and diastolic blood pressure in the middle and large infarction group were significantly higher than those in the small infarction group(P<0.01);There were no significant differences in fasting blood glucose and thrombolytic time window between the small infarction group and the middle and large infarction group(P>0.05).The NIHSS score,fasting blood glucose,systolic blood pressure,diastolic blood pressure and thrombolytic time window in the hemorrhagic transformation group were significantly higher than those in the non hemorrhagic transformation group(P<0.01).The expression levels of S100B,HIF-1α,NGB and AQP7 protein in middle and large infarction group were significantly higher than those in small infarction group(P<0.01).The expression levels of S100B,HIF-1α,NGB and AQP7 protein in the hemorrhagic transformation group were significantly higher than those in the non hemorrhagic transformation group(P<0.01).The expression levels of S100B,HIF-1α,NGB and AQP7 in NIHSS score>15 group were significantly higher than those in NIHSS score≤15 group(P<0.01).ConclusionThe increase of serum S100B,HIF-1α,NGB and AQP7 levels is involved in the expansion of infarct volume,bleeding transformation after intravenous thrombolysis and the increase of NIHSS score in patients with ischemic stroke,which can be used to evaluate the severity of the disease and the potential bleeding risk of intravenous thrombolysis.