摘要
目的 探讨雌激素对缺血性脑卒中的神经保护机制.方法 选择40例经临床与影像学检查证实为大脑中动脉梗死的男性患者作为研究对象.按随机原则分为激素治疗组和常规治疗对照组,两组综合治疗相同;激素组加用己烯雌酚2 mg,每日2次.于治疗前及治疗后3、7、14和21 d取血测定雌二醇(E2)、睾酮(Ts)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、白细胞介素-1β(IL-1β)、一氧化氮(NO),并对患者进行美国国立卫生院神经功能缺损评分(NIHSS)评定.结果 与治疗前比较,激素组治疗后3 d起HDL-C、E:均明显升高,TC、LDL-C均明显降低,且较常规组变化明显,差异均有统计学意义(P均＜0.05);而TG、Ts变化不明显.常规组治疗后14 d起N0、IL-1β明显升高(P均＜0.05);而激素组自治疗后3 d起NO、IL-1β均较常规组显著降低,NIHSS于治疗后14 d和21 d明显降低(P均＜0.05).结论 小剂量雌激素对急性缺血性脑卒中具有保护作用,其作用机制可能是通过调节血脂、抗免疫性炎症、调节NO合成等发挥作用.小剂量、短时程使用雌激素对急性缺血性脑卒中患者可能是有益的.
Objective To investigate the mechanism of protective effect of estrogen on cerebral damage in ischemic stroke by measuring the estrogen2 (E2),blood lipid,interleukin-1β (IL-1β),nitric oxide (NO),and also assessment according to national institute of health stroke scale (NIHSS) score,in order to improve the treatment of cerebral infarction.Methods Forty male patients,in whom cerebral infarction due to thrombosis of middle cerebral artery was confirmed by CT or magnetic resonance imaging (MRI),were divided into two groups : E2 therapy (20 cases) and routine therapy (20 cases).Routine therapy was the same in both groups,except 2 mg of Ez was orally given (2 times a day) to the E2 therapy group.E2,testosterone (Ts),total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C),IL-1β,NO,and NIHSS score were measured in each patient at time points of 0,3,7,14 and 21 days.Results In E2 group,HDL-C and Ez were increased significantly,and TC and LDL-C were decreased significantly from 3 days on after treatment,and the changes were obviously more marked than that of routine therapy group (all P＜0.05).The changes in TG and Ts were not obvious.NO,IL-1β were increased significantly (both P＜0.05),and NIHSS score was decreased in routine group form 14 days on after treatment.NO and IL-1β in E2 group were lower than those in routine therapy group from 3 days on,and the NIHSS score was significantly lower on 14 days and 21 days in E2 group (both P＜0.05).Conclusion The protective effect of E2 is obvious.It may be due to the results of modulation of blood fat,anti-inflammation and modulation of NO production by the action of E2.Low dose and short time therapy of E2 may be beneficial to the patient.
出处
《中华危重病急救医学》
CAS
CSCD
北大核心
2008年第11期-,共3页
Chinese Critical Care Medicine
基金
北京市医药卫生科研基金
