论文部分内容阅读
目的观察脑出血患者血浆溶血磷脂类分子(LPA/AP)含量变化的特点以及微创血肿清除术联合镁制剂的影响,探索脑出血后病理生理学机制及有效的干预方法。方法选取脑出血患者328例,测定其血浆溶血磷脂酸(LPA)及其相似磷脂(AP)的含量变化,并与359例脑梗死患者进行比较,年龄匹配的健康体检者作为对照组。同时观察微创血肿清除术及镁制剂对脑出血患者血浆LPA、AP含量及预后的影响。结果发病24h脑梗死组血浆LPA的含量[(4.23±0.61)μmol/L]显著高于脑出血组[(2.66±0.44)μmol/L,P<0.01]及对照组[(2.54±0.39)μmol/L,P<0.01]。脑出血组血浆AP含量[(6.65±0.76)U]显著高于脑梗死组[(5.35±0.57)U,P<0.01]及对照组[(4.09±0.48)U,P<0.01]。发病1周、2周,脑出血组血浆AP含量仍高于脑梗死组和对照组(P<0.01)。微创钻颅血肿清除术及镁制剂治疗能够显著降低脑出血患者血浆AP含量(P<0.01),改善患者预后。结论脑出血患者血浆AP含量显著升高,提示脑出血后2周内均存在膜损伤;微创钻颅血肿清除术联合镁制剂治疗能够有效降低血浆AP含量,改善患者预后,具有神经保护作用。
Objective To observe the changes of plasma lysophospholipid molecules (LPA / AP) in patients with intracerebral hemorrhage and the effect of minimally invasive hematoma removal combined with magnesium preparations and to explore the pathophysiological mechanisms and effective intervention methods after intracerebral hemorrhage. Methods 328 patients with intracerebral hemorrhage were selected and their plasma lysophosphatidic acid (LPA) and its analogous phospholipids (AP) were assayed. The results were compared with 359 patients with cerebral infarction. Age matched healthy subjects were used as control group. At the same time, we observed the effects of minimally invasive hematoma and magnesium preparations on plasma LPA and AP levels and prognosis in patients with intracerebral hemorrhage. Results The level of LPA in cerebral infarction group [(4.23 ± 0.61) μmol / L] was significantly higher than that in ICH group [(2.66 ± 0.44) μmol / L, P <0.01] and [(2.54 ± 0.39) /L,P<0.01]. The level of plasma AP in ICH group was significantly higher than that in ICH group ([(6.65 ± 0.76) U] [(5.35 ± 0.57) U, P <0.01] and control group (4.09 ± 0.48) U, P <0.01. The incidence of AP in plasma in cerebral hemorrhage group was still higher than that in cerebral infarction group and control group (P <0.01). Minimally invasive drilling skull hematoma and magnesium treatment can significantly reduce the plasma AP levels in patients with intracerebral hemorrhage (P <0.01), improve prognosis. Conclusions Plasma AP levels in patients with intracerebral hemorrhage are significantly increased, suggesting that there is membrane injury within 2 weeks after intracerebral hemorrhage. Minimally invasive drilling craniotomy and magnesium preparations can effectively decrease plasma AP levels and improve prognosis of patients with neuroprotection.