静脉替罗非班治疗对急性脑梗死患者Lp-PLA2、Galectin-1水平的影响

Effect of treatment with tirofiban on levels of Lp-PLA2 and Galectin-1 in patients with acute cerebral infarction

目的观察静脉替罗非班治疗急性脑梗死(ACI)患者血清中脂蛋白相关磷脂酶A_(2)(Lp-PLA_(2))和半乳糖凝集素-1(Galectin-1)水平的变化及临床疗效。方法选取神经内科收治的48例接受静脉替罗非班治疗的ACI患者作为观察组,选择同期健康体检者46例作为对照组。抽取对照组当日静脉血,观察组患者治疗前及经静脉替罗非班治疗第1天、第7天、第30天时抽取静脉血。比较两组间以及观察组患者治疗前后血清Lp-PLA_(2)、Galectin-1水平;观察组患者治疗前后改良Rankin量表(mRS)评分。结果观察组患者在治疗前以及治疗第1、7、30天的血清Lp-PLA_(2)水平分别为(301.16±1.24)、(264.25±0.98)、(198.36±1.02)、(251.48±1.13)ng/ml,均高于对照组的(148.25±1.47)ng/ml(P<0.05);观察组患者经替罗非班治疗后血清Lp-PLA_(2)水平较治疗前逐渐下降,但治疗后第30天血清Lp-PLA_(2)水平较治疗后第7天升高(P<0.05)。观察组患者在治疗前以及治疗第1、7、30天的血清Galectin-1水平分别为(314.00±93.62)、(203.00±85.41)、(145.00±81.34)、(198.00±83.46)pg/ml,均高于对照组的(96.00±42.33)pg/ml(P<0.05)。观察组患者经替罗非班治疗后血清Galectin-1水平较治疗前逐渐下降,但治疗后第30天的血清Galectin-1水平较治疗后第7天升高(P<0.05)。观察组治疗前mRS评分为(3.04±0.43)分,治疗90 d后mRS评分为(1.05±0.31)分,较治疗前降低,差异有统计学意义(P<0.05)。结论采用静脉替罗非班治疗,可降低ACI患者中血清Lp-PLA_(2)、Galectin-1水平,促进神经功能恢复。

Objective To observe the changes of serum lipoprotein-associated phospholipase A_(2)(Lp-PLA_(2))and Galectin-1 in patients with acute cerebral infarction(ACI)after intravenous tirofiban.Methods 48 cases of ACI patients treated with intravenous tirofiban in the Department of Neurology were selected as the observation group,and 46 healthy subjects were selected as the control group.Venous blood was extracted from the control group on admission,and from the observation group before treatment and on day 1,day 7 and day 30 after intravenous tirofiban.Serum Lp-PLA_(2)and Galectin-1 levels were compared between the two groups and before and after treatment in the observation group,as well as modified Rankin Scale(mRS)scores before and after treatment in observation group.Results Serum Lp-PLA_(2)levels in the observation group were(301.16±1.24),(264.25±0.98),(198.36±1.02)and(251.48±1.13)ng/ml before treatment and on the 1st,7th and 30th days of treatment,which was higher than(148.25±1.47)ng/ml in the control group(P<0.05).After tirofiban treatment,the serum Lp-PLA_(2)level in the observation group gradually decreased compared with that before treatment,but the serum Lp-PLA_(2)level on the 30th day of treatment was higher than that on the 7th day of treatment(P<0.05).Serum Galectin-1 levels in the observation group were(314.00±93.62),(203.00±85.41),(145.00±81.34)and(198.00±83.46)pg/ml before treatment and on the 1st,7th and 30th days of treatment,which was higher than(96.00±42.33)pg/ml in the control group(P<0.05).After tirofiban treatment,serum Galectin-1 level in the observation group was gradually decreased compared with that before treatment,but the serum Galectin-1 level on the 30th day of treatment was increased compared with that on the 7th day of treatment(P<0.05).mRS Score of the observation group was(3.04±0.43)points before treatment,and(1.05±0.31)points after 90 d of treatment,which was lower than that before treatment,and the difference was statistically significant(P<0.05).Conclusion Intravenous tirofiban can decrease the serum levels of Lp-PLA_(2)and Galectin-1 and promote the recovery of neurological function in patients with ACI.