本研究探讨磁敏感加权成像(SWI)检出的脑微出血(CMBs)、不对称皮层静脉征(ACVS)与急性脑梗死(ACI)患者预后的关系。选取确诊为ACI并且接受静脉溶栓治疗的87例患者作为研究对象,所有研究对象均接受SWI扫描,按照改良Rankin量表(mRS),将患...本研究探讨磁敏感加权成像(SWI)检出的脑微出血(CMBs)、不对称皮层静脉征(ACVS)与急性脑梗死(ACI)患者预后的关系。选取确诊为ACI并且接受静脉溶栓治疗的87例患者作为研究对象,所有研究对象均接受SWI扫描,按照改良Rankin量表(mRS),将患者分为预后良好(良好组58例)和预后不良(不良组29例)两组,对比两组的CMBs、ACVS的检出率,运用受试者操作特征(ROC)曲线方法探讨两项指标在预测ACI静脉溶栓治疗后患者的预后结局方面的作用。结果显示,良好组的CMBs、ACVS检出率显著低于不良组(P<0.05);Logistic模型结果显示,基线NIHSS评分越高、溶栓24 h NIHSS评分越高、合并高血压、大脑中动脉重度狭窄、发生CMBs和ACVS,均是ACI患者不良预后的独立危险因素(P<0.05),ASPECTS梗死病灶面积评分降低是ACI患者不良预后的独立危险因素(P<0.05)。SWI可早期发现ACI患者静脉溶栓后的CMBs、ACVS特征,可评估患者不良预后的风险。展开更多
OBJECTIVE:To explore whether the paraventricular nucleus(PVN)participates in regulation of the antimyocardial ischemia-reperfusion injury(MIRI)effect of electroacupuncture(EA)and whether this is achieved through the P...OBJECTIVE:To explore whether the paraventricular nucleus(PVN)participates in regulation of the antimyocardial ischemia-reperfusion injury(MIRI)effect of electroacupuncture(EA)and whether this is achieved through the PVN-interposed nucleus(IN)neural pathway.METHODS:The modeling method of myocardial ischemia reperfusion injury was achieved by ligating the left anterior descending coronary artery in SpragueDawley rats.We used the Powerlab multi-channel physiological recorder system to record electrocardiograms and analyze the changes in ST segment displacement;2,3,5-Triphenyltetrazolium chloride staining was used to observe the percentage of myocardial infarction areas.Detecting cardiac troponin I(cTnI),lactate dehydrogenase(LDH)in serum was done with an enzyme-linked immunosorbent assay kit.Morphological changes in the myocardium were detected in each group with hematoxylin-eosin staining of paraffin sections.Detection of c-fos protein expression in the PVN of the hypothalamus was done with the immuneofluorescence method.The Plexon multi-channel acquisition system recorded PVN neuron discharges and local field potentials in each group of rats.Offline Sorter software was used for cluster analysis.Neuro Explorer software was used to perform autocorrelation,raster and frequency characteristics and spectral energy analysis of neuron signals in each group.RESULTS:Compared with the MIRI model group,the areas of myocardial infarction in the EA group were significantly reduced;the expression of cTnI,LDH in serum was decreased significantly.The firing frequency of pyramidal cells in the PVN was significantly increased and the spectrum energy map showed energy was reduced,c-fos expression in PVN was reduced,this indicated that neuronal activity in the PVN participates in the effect of EA improving myocardial injury.In addition,we used the kainic acid method to lesion the IN and observed that the effect of EA was weakened.For example,the area of myocardial infarction of lesion IN+EA group in rats was significantly increased compared with that resulting from EA group,the expression of cTnI,LDH in serum was significantly increased,the firing frequency of pyramidal cells in the PVN was significantly reduced.A spectral energy diagram shows that the energy after damage was higher than that of EA group.At the same time,the expression of c-fos in the PVN increased again.CONCLUSION:Our results indicated that the PVN-IN nerve pathway may participate as an effective pathway of EA to improve the effect of myocardial injury.展开更多
文摘本研究探讨磁敏感加权成像(SWI)检出的脑微出血(CMBs)、不对称皮层静脉征(ACVS)与急性脑梗死(ACI)患者预后的关系。选取确诊为ACI并且接受静脉溶栓治疗的87例患者作为研究对象,所有研究对象均接受SWI扫描,按照改良Rankin量表(mRS),将患者分为预后良好(良好组58例)和预后不良(不良组29例)两组,对比两组的CMBs、ACVS的检出率,运用受试者操作特征(ROC)曲线方法探讨两项指标在预测ACI静脉溶栓治疗后患者的预后结局方面的作用。结果显示,良好组的CMBs、ACVS检出率显著低于不良组(P<0.05);Logistic模型结果显示,基线NIHSS评分越高、溶栓24 h NIHSS评分越高、合并高血压、大脑中动脉重度狭窄、发生CMBs和ACVS,均是ACI患者不良预后的独立危险因素(P<0.05),ASPECTS梗死病灶面积评分降低是ACI患者不良预后的独立危险因素(P<0.05)。SWI可早期发现ACI患者静脉溶栓后的CMBs、ACVS特征,可评估患者不良预后的风险。
基金Supported by National Natural Science Foundation of China:Mechanism of GABA/Glu Neural Circuit in Lateral HypothalamusParietal Nucleus in Alleviating Myocardial Ischemia-Reperfusion Injury by Acupuncture Preconditioning(82074536)Study on the Protective Effect of Acupuncture Pretreatment on Myocardial Ischemia-Reperfusion Injury Based on Hypothalamic-Cerebellar Neural Circuit(81774414)+2 种基金Mechanism of GABA Neural Circuit in the Paraventricular Nucleus of Hypothalamus and Ventrolateral Region of Medulla Oblongata in Alleviating Myocardial Ischemia-Reperfusion Injury Induced by Acupuncture Pretreatment(82104999)Natural Science Foundation of Anhui Province the Central Regulatory Mechanism of Acupuncture Regulating Cardiac Function(2108085Y30)Anhui Province University Outstanding Top Talent Cultivation Funding Project(gxgwfx2019025)
文摘OBJECTIVE:To explore whether the paraventricular nucleus(PVN)participates in regulation of the antimyocardial ischemia-reperfusion injury(MIRI)effect of electroacupuncture(EA)and whether this is achieved through the PVN-interposed nucleus(IN)neural pathway.METHODS:The modeling method of myocardial ischemia reperfusion injury was achieved by ligating the left anterior descending coronary artery in SpragueDawley rats.We used the Powerlab multi-channel physiological recorder system to record electrocardiograms and analyze the changes in ST segment displacement;2,3,5-Triphenyltetrazolium chloride staining was used to observe the percentage of myocardial infarction areas.Detecting cardiac troponin I(cTnI),lactate dehydrogenase(LDH)in serum was done with an enzyme-linked immunosorbent assay kit.Morphological changes in the myocardium were detected in each group with hematoxylin-eosin staining of paraffin sections.Detection of c-fos protein expression in the PVN of the hypothalamus was done with the immuneofluorescence method.The Plexon multi-channel acquisition system recorded PVN neuron discharges and local field potentials in each group of rats.Offline Sorter software was used for cluster analysis.Neuro Explorer software was used to perform autocorrelation,raster and frequency characteristics and spectral energy analysis of neuron signals in each group.RESULTS:Compared with the MIRI model group,the areas of myocardial infarction in the EA group were significantly reduced;the expression of cTnI,LDH in serum was decreased significantly.The firing frequency of pyramidal cells in the PVN was significantly increased and the spectrum energy map showed energy was reduced,c-fos expression in PVN was reduced,this indicated that neuronal activity in the PVN participates in the effect of EA improving myocardial injury.In addition,we used the kainic acid method to lesion the IN and observed that the effect of EA was weakened.For example,the area of myocardial infarction of lesion IN+EA group in rats was significantly increased compared with that resulting from EA group,the expression of cTnI,LDH in serum was significantly increased,the firing frequency of pyramidal cells in the PVN was significantly reduced.A spectral energy diagram shows that the energy after damage was higher than that of EA group.At the same time,the expression of c-fos in the PVN increased again.CONCLUSION:Our results indicated that the PVN-IN nerve pathway may participate as an effective pathway of EA to improve the effect of myocardial injury.
