【摘要】 目的:探讨急性缺血性脑卒中患者发病48 h内热休克因子1(Hsf-1)水平及其与不同病因学亚型的关系。方法:对62例缺血性脑卒中患者进行TOAST病因学分型、用美国国立卫生研究院神经功能缺损评分(NIHSS)评估神经功能缺损,发病3个月时改良Rankin量表(mRS)评分评估预后。并与正常对照组(31例)用逆转录PCR法检测外周血单核细胞中Hsf-1mRNA的表达水平。结果:神经功能缺损轻型与重型之间差异无统计学意义(P=0.138),大动脉粥样硬化性卒中(LAA)组的Hsf-1表达高于小动脉闭塞性卒中(SAA)组,且差异具有统计学意义(P<0.01),按NIHSS进一步分层后统计学差异仍存在,预后良好组Hsf-1表达高于预后不良组且差异具有统计学意义(P=0.007)。结论:Hsf-1表达测定对缺血性卒中病因学分型有一定的参考价值,并可能成为缺血性卒中患者病情评估的参考指标之一。更多还原

【Abstract】 Objective: To investigate the heat shock factor-1(Hsf-1) expression within the first 48 hours from onset in acute ischemic stroke(AIS) patients and its relationship with stroke subtype.Methods: The expression of Hsf-1 mRNA in peripheral blood mononuclear cell(PBMC) was determined using reverse transcriptional polymerase chain(RT-PCR) from 62 AIS patients and 31 healthy controls.Patients were classified into subtypes according to TOAST criteria.AIS patients were examined with National institutes of health stroke scale(NIHSS) on admission and the modified Rankin scale score(mRS) at 3 months after admission.Results: There is no significant difference between mild and severe types.Whether stratified analysis is used,the mRNA expression of Hsf-1 in PBMC of large-artery atherosclerosis(LAA) group was evidently higher than that in small-artery occlusion(SAA) group.mRS at the post-onset 3 month were positively correlated with the expression of Hsf-1 at the post-onset 48 hours.Conclusion: The changes of Hsf-1 level may reflect the etiological and pathophysiological diversity of AIS.Hsf-1 might play a role in etiological diagnosis of ischemic stroke subtype.The Hsf-1 level within 48 hours after onset could indicate the prognosis in patients with AIS.更多还原