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目的:研究高血压脑出血患者经颅多普勒(TCD)对颅内高压及神经损伤程度的评估。方法:选择2014年8月~2017年2月期间因高血压脑出血住院治疗的患者作为脑出血组,同期体检的健康者作为对照组;采用TCD对高血压组患者患侧及健侧大脑中动脉的PI进行测定,同时进行腰穿并测定颅内压;另取两组受试者的血清并测定炎症反应细胞因子以及神经损伤标志分子的含量。结果:脑出血组患者患侧大脑中动脉的PI水平显著高于健侧(P<0.05),且与颅内压水平呈正相关(P<0.05);脑出血组患者血清中IL-1β、TNF-α、ICAM-1、MMP9、YKL-40、Asp、Glu、NPY、NSE、GFAP的含量显著高于对照组(P<0.05),高PI水平脑出血患者血清中IL-1β、TNF-α、ICAM-1、MMP9、YKL-40、Asp、Glu、NPY、NSE、GFAP的含量显著高于低PI水平脑出血患者(P<0.05)。结论:高血压脑出血患者TCD参数能够评估颅内压升高的程度以及神经损伤的程度。
Abstract：Objective:To evaluate the assessment of intracranial hypertension and nerve injury in patients with hypertensive cerebral hemorrhage by transcranial Doppler(TCD).Methods:The patients who were hospitalized for hypertensive cerebral hemorrhage between August 2014 and February 2017 were selected as the cerebral hemorrhage group and healthy subjects who received physical examination during the same period were selected as the control group;TCD was used to determine the PI of affected-side and unaffected-side middle cerebral artery in cerebral hemorrhage group and lumbar puncture was done to measure intracranial pressure.The serum was collected from the two groups to detect the levels of inflammatory cytokines and nerve injury markers.Results:PI level in affected-side middle cerebral artery of cerebral hemorrhage group was significantly higher than that in the unaffected-side and positively correlated with intracranial pressure level;serum IL-1β,TNF-α,ICAM-1,MMP9,YKL-40,Asp,Glu,NPY,NSE and GFAP levels of cerebral hemorrhage group were significantly higher than those of control group,and serum IL-1β,TNF-α,ICAM-1,MMP9,YKL-40,Asp,Glu,NPY,NSE and GFAP levels of cerebral hemorrhage group of patients with high PI level were significantly higher than those of cerebral hemorrhage group of patients with low PI level.Conclusion:TCD parameters can evaluate the degree of intracranial pressure increase and nerve injury in patients with hypertensive cerebral hemorrhage.
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基本信息:
DOI：10.13210/j.cnki.jhmu.20171220.001
中图分类号:R544.1;R743.34
引用信息:
[1]郭俐,李志勇,杨荃荃.高血压脑出血患者TCD对颅内高压及神经损伤程度的评估价值[J].海南医学院学报,2018,24(01):129-132+137.DOI:10.13210/j.cnki.jhmu.20171220.001.
基金信息:
四川省卫生和计划生育委员会科研课题(17PJ407)~~
2017-12-20
2017-12-20
2017-12-20