| 大脑中动脉区急性缺血性脑卒中血浆hs-CRP、HCY、FIB与经颅多普勒血流动力学分型的临床研究 |
| Alternative Title | The clinical research between plasma hs-CRP，HCY and FIB level of acute ischemic stroke in the middle cerebral artery region and Transcranial Doppler hemodynamic types
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| 包红辉 |
| Thesis Advisor | 刘宁
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| 2015-05-21
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| Degree Grantor | 兰州大学
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| Place of Conferral | 兰州
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| Degree Name | 硕士
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| Keyword | 急性缺血性脑卒中
超敏C反应蛋白
同型半胱氨酸
纤维蛋白原
经颅多普勒
血流动力学
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| Abstract | 目的炎症不仅是脑卒中后所致的结果，而且参与神经组织的损伤。因此本文将探索上述血浆生物标志物对MCA血流动力学分型的影响，以及不同血流动力学分型间神经缺损和早期神经缺损症状改善的比较。方法共有AIS 67例入组，采用AU-5800对血浆hs-CRP、HCY进行检查。并行TCD和颈动脉彩超检查，依据TIBI标准，动力学分为闭塞和非闭塞组。神经缺损程度通过NIHSS评估。
结果 本文中闭塞组26例，非闭塞组41例，入院时和发病后第7天，2组间NIHSS评分均具有统计学意义（P﹤0.05）。本文中Hhs-CRP 10例， Lhs-CRP者57例，2组间血流动力学分型比较，差异具有统计学意义（P﹤0.05）；同理HHCY患者46例， NHCY者21例，差异仍有统计学意义（P﹤0.05）；HFIB患者13例， LFIB者54例，差异具有统计学意义（P﹤0.05）。二项分类Logistic显示，性别、糖尿病、NIHSS和FIB为闭塞分型的预测因素。结论根据血流动力学分型，闭塞较非闭塞组神经功能缺损严重和早期神经缺损症状改善率低；急性期高水平的血浆hs-CRP、HCY和FIB对受累血管的血流动力学闭塞分型产生影响，性别、糖尿病、NIHSS评分以及FIB是闭塞分型的预测因素。 |
| Other Abstract | Inflammation is not only a result of stroke ,but also participating in the injury of nervous tissue in acute ischemic stroke, there is few study about the relationship between the classification of acute ischemic stroke beyond thrombolytic time window(using transcranial Doppler hemodynamics to test the ipsilateral MCA) and the level of plasma hs-CRP, HCY and FIB. Therefore, the purpose of this study is to explore the impact of the biomarker to the classification of hemodynamic MCA, and compare the degree of neurological deficit and the improvement rate of early symptoms of neurological defects between difference hemodynamic classification.Methods: We prospectively included 67 patients with acute ischemic stroke. Plasma hs-CRP , HCY were obtained from patients using automatic biochemical analyzer(AU–5800), it is defined as Hhs-CRP and HHCY when the plasma concentrations exceeded 3.0mg / L and 15umol / L, while using coagulation method for the determination of plasma fibrinogen, it is defined as HFIB when the plasma concentrations exceeded 3.5g / L. Using transcranial Doppler with 2 MHz and the Philips iU Elite ultrasound instrument with 10MHz to perform TCD and carotid ultrasound examination 24h after admission. According to TIBI (Thrombolysis in Brain Ischemia) standard and spectrum characteristics, the hemodynamics types of ipsilateral middle cerebral artery is divided as the occlusion group and the non-occlusive group. Stroke severity was analyzed by the National Institutes of Health Stroke Scale (NIHSS).The improvement of early symptoms of neurological defects is defined as NIHSS score decreasing 6 points comparing with admission or scored 0～4 points.Results: In this paper, the occlusion group had 26 cases, non-occlusion group had 41 cases, the peak systolic velocity, end-diastolic flow velocity and mean flow velocity of ipsilateral middle cerebral artery between the two groups had a significant difference(P <0.001): 48.31±26.42 vs. 102.78±36.90、14.50±12.20 vs. 41.02±20.40 and 29.08±15.58 vs. 63.78±25.13.Between the occlusion group and non-occlusive group, there was a significant difference in the degree of NIHSS score on admission date and 7 days after the onset(P <0.05, 7.38 ± 4.85 vs. 5.41 ± 2.78 and 5.42 ± 3.79 vs. 3.32 ± 2.30). There was a significant difference in the level of FIB in the acute phase (P <0.05,3.16 ± 0.68 vs. 2.80 ± 0.52). Between occlusion group and non-occlusion group, patients with improvement of early symptoms... |
| URL | 查看原文
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| Language | 中文
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| Document Type | 学位论文
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| Identifier | https://ir.lzu.edu.cn/handle/262010/223691
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| Collection | 学院待认领
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| Affiliation | 临床医学院
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Recommended Citation
GB/T 7714 |
包红辉. 大脑中动脉区急性缺血性脑卒中血浆hs-CRP、HCY、FIB与经颅多普勒血流动力学分型的临床研究[D]. 兰州. 兰州大学,2015.
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