【作者】 侯宇；

【导师】 孙长凯；

【作者基本信息】 大连医科大学 ， 神经病学， 2006， 硕士

【摘要】 目的:急性缺血性脑卒中(Acute Ischemic Stroke,AIS)是一种发病率高,致残率高的脑疾患。尽管目前对脑缺血损伤机制及脑卒中的预防取得了较大进展,但至今对于脑卒中几乎没有明显有效的治疗方法。谷氨酸(Glu)是中枢神经系统主要的兴奋性神经递质。在脑缺血时,Glu大量释放和对Glu受体过度刺激,导致神经元兴奋、溃变、死亡,产生兴奋性毒性。β淀粉样蛋白(β-amyloid Peptide,Aβ)是阿尔茨海默病的主要致病因子。由β淀粉样前体蛋白(β-Amyloid Precursor Protein,βAPP)裂解产生。根据βAPP的剪切部位不同可产生Aβ1-40和Aβ1-42,有研究发现Aβ除了可以直接或间接地通过作用于细胞,增强、放大各种伤害性刺激使神经元发生死亡外,还可能是一种与兴奋过程紧密相关的重要稳态物质。Aβ亦具有潜在的多重协同作用影响Glu功能,包括提高其释放、抑制其摄取和增加神经元的易感性。因此脑缺血患者血中Aβ的变化亦可能与Glu水平存在某种联系。但目前关于这方面的研究尚不够深入。我们对AIS患者在入院时及7天后的血中的Glu、Aβ1-40和Aβ1-42水平进行了检测。探讨其变化的相关关系及其可能的临床意义,了解其对预后的影响。方法:我们选取了27例AIS患者和11例年龄相当的健康体检者作为对照,分别对对照组和AIS患者(入院时及1周后)的血中的Glu、Aβ1-40和Aβ1-42水平进行检测。应用双抗体夹心酶联免疫吸附法(ELISA)测定血中Aβ1-40和Aβ1-42的水平,应用高效液相色谱法(HPLC)测定血中Glu水平。应用美国国立卫生研究院卒中量表(NIHSS)及日常生活活动(ADL)量表Barthel指数(BI)记分法的评分标准对AIS患者在更多还原

【Abstract】 ObjectiveAcute ischemic stroke(AIS) damage represents a major source of morbidity and mortality in society. Despite of advances in acute and prophylactic therapies,to date, few effective therapies have been realized to treat stroke and once promising avenues have not proven clinically useful. Glutamate(Glu) is the main excitatory neurotransmitter in the central nervous system(CNS).Neuronal death induced by most Glu release and overactive Glu receptor after ischemia stroke. In the brains of Alzheimer’s disease patients amyloid beta-peptide(Aβ) is the major component of senile plaque. Aβis formed by sequential breakdown ofβamyloid precursor protein(βAPP). Cleavage ofβAPP by -secretase results in the production of the Aβ1–40 and Aβ1–42. Including the neurotoxicity induced by Aβstraightly or indirectly ,recent studies suggested that Aβmight be an important steady substance involved in the process of nerve excitation in the CNS. The potentially synergistic multiple effects of Aβon Glu function, including enhancing its release, preventing its uptake, and increasing neuronal vulnerability .There may be some correlations between Aβand Glu in patients with acute ischemic stroke.But the correlations have not been kown clearly.Thus we investigate the changes and clinical implications of blood Aβ1–40 ,Aβ1–42 and Glu levels and the prognosis in patients with acute ischemic stroke.MethodsWe prospectively enrolled 27 patients with acute ischemic stroke and 11 age-matched controls to detect the serum Glu,Aβ1-40 and plasma Aβ1-42 (at admission and one week after admission). The blood Aβlevels were更多还原