血浆lp-pla2对急性缺血性脑卒中诊断的临床研究-clinical study of plasma lp - pla 2 in diagnosis of acute ischemic stroke.docxVIP

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血浆lp-pla2对急性缺血性脑卒中诊断的临床研究-clinical study of plasma lp - pla 2 in diagnosis of acute ischemic stroke.docx

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血浆lp-pla2对急性缺血性脑卒中诊断的临床研究-clinical study of plasma lp - pla 2 in diagnosis of acute ischemic stroke

目录中文摘要············································································································1英文摘要············································································································4研究论文血浆Lp-PLA2对急性缺血性脑卒中诊断的临床研究前言············································································································8材料与方法···························································································9结果········································································································12附图········································································································14附表········································································································16讨论········································································································18结论········································································································22参考文献·································································································23综述血浆Lp-PLA2与缺血性脑卒中关系的研究进展·······························28致谢··········································································································43个人简历········································································································44血浆Lp-PLA2对急性缺血性脑卒中诊断的临床研究摘要目的：缺血性脑卒中的诊断主要依靠患者的症状/体征以及CT/MRI等影像学检查，目前临床仍缺乏快速、敏感以及特异性的血液生化学指标。最新研究表明炎性反应是导致动脉粥样硬化和缺血性卒中的重要机制之一，人血浆脂蛋白相关磷脂酶A2(Lp-PLA2)由单核巨噬细胞产生，参与氧化低密度脂蛋白的代谢，促进血管特异性炎症和粥样硬化的进程，有可能是提示缺血性脑卒中的发生及动脉粥样硬化型脑卒中的重要依据。本研究应用免疫增强比浊法检测急性缺血性脑卒中患者血浆Lp-PLA2水平，并与健康体检者对比，以探讨血浆Lp-PLA2水平是否具有提示急性缺血性脑卒中的诊断及分型的价值，为急性缺血性卒中的诊断提供新的思路，同时为进一步个体化治疗提供理论依据。方法：1材料1.1研究对象选取河北医科大学第二医院神经内科2014年12月至2015年12月住院的急性缺血性脑卒中病人90例为观察组，其中男性74例，女性16例,年龄45~80岁，平均年龄58.58±8.46岁。就诊时间为发病后4小时~3天。首次发病者66例，复发者24例。另一组为我院体检中心健康体检者90例为对照组，其中男性74例，女性16例，年龄45~80岁，平均年龄59.30±8.43岁。入排标准入组标准：1)观察组的患者均符合1995年全国第4届脑血管病学术会议所制定的《各类脑血管疾病诊断要点》脑梗死诊断标准，均行颅脑MRI+DWI