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目的:探讨脑梗死急性期动静脉血氧含量差值(S_(a-v)O_2)水平与超敏C反应蛋白(hs-CRP)、凋亡蛋白(bax)、B细胞淋巴瘤/白血病-2(bcl-2)、α肿瘤坏死因子(TNF-a)的关系。方法:选取汕头市潮阳区大峰医院发病72 h内的急性脑梗死患者280例,入院后3 d测定Sa-vO2及hs-CRP、bax、bcl-2、TNF-a水平,按SaO_2及S_(a-v)O_2达标与否随机分为低S_(a-v)O_2组(<50 mm Hg)、中S_(a-v)O_2组(50~70 mm Hg)及高S_(a-v)O_2组(>70 mm Hg),比较3组患者的凋亡因子水平,分析S_(a-v)O_2水平对脑梗死急性期相关促凋亡及抑凋亡因子的影响。结果:中S_(a-v)O_2组hs-CRP、bax、TNF-a水平明显低于低S_(a-v)O_2组及高S_(a-v)O_2组检测结果,抑凋亡因子bcl-2在S_(a-v)O_2组中的表达高于低S_(a-v)O_2组及高S_(a-v)O_2组,差异有着统计学意义。结论:S_(a-v)O_2水平可预测脑梗死患者细胞凋亡情况,为脑梗死患者的病情发展及预后提供新的预测指标。
Objective: To investigate the relationship between the difference of arteriovenous oxygen content (S_ (av) O_2) and the levels of hs-CRP, bax, B-cell lymphoma / leukemia-2 bcl-2), alpha tumor necrosis factor (TNF-a). Methods: Two hundred and eighty patients with acute cerebral infarction within 72 hours from Daya Hospital of Chaoyang District of Shantou City were enrolled. The levels of Sa-vO2, hs-CRP, bax, bcl-2 and TNF- av O 2 group (50-70 mm Hg) and high S av 2 group (> 70 mm Hg) were randomly divided into low S_ (av) O_2 group (<50 mm Hg) ). The level of apoptosis in the three groups of patients was compared. The effect of S_ (av) O_2 level on apoptosis and apoptosis-related factors in acute stage of cerebral infarction were analyzed. Results: The levels of hs-CRP, bax and TNF-a in S_ (av) O_2 group were significantly lower than those in low S_ (av) O_2 group and high S_ (av) av) O 2 group was higher than that of low S_ (av) O_2 group and high S_ (av) O_2 group, the difference was statistically significant. CONCLUSION: S_ (a-v) O_2 level can predict the apoptosis of patients with cerebral infarction and provide a new predictor for the progression and prognosis of patients with cerebral infarction.