摘要
目的探讨电针对脑梗死患者血清血管内皮生长因子(vascular endothelial growth factor,VEGF)、血管内皮生长因子受体1/fms样酪氨酸激酶1(VEGF receptor-1/fms-like tyrosine kinase-1,Flt-1)、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)的表达以及临床效果的影响。方法收集医院诊治的急性脑梗死患者160例为研究对象,采用随机数字表法将患者分为对照组(80例)与研究组(80例),对照组给予右旋糖酐常规治疗,研究组给予电针治疗。采用实时荧光定量聚合酶链反应(qRT-PCR)检测VEGF mRNA、Flt-1 mRNA的表达量;采用酶联免疫吸附试验(ELISA)检测患者血清BDNF的水平;比较两组患者的临床治疗效果、神经功能缺损评分与ADL评分;采用ELISA法检测血清白细胞介素-1β(interleukin-1β,IL-1β)、白细胞介素6(interleukin-6,IL-6)、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)的水平;检测患者脑血流动力学指标:颈总动脉的平均血流量(Qm)、平均血流速度(Vm)、外周阻力(Rv)、动态阻力(DR)。结果与对照组比较,研究组患者好转率、总有效率显著升高(P<0.05),无变化发生率与恶化率显著降低(P<0.05);治疗后,两组神经功能缺损评分显著降低(P<0.05),ADL评分显著升高(P<0.05),且对照组与研究组比较差异有统计学意义(P<0.05);治疗后,与对照组比较,研究组患者血清VEGF mRNA、BDNF的表达水平显著升高(P<0.05),Flt-1 mRNA的表达水平显著降低(P<0.05),IL-1β、IL-6、hs-CRP、TNF-α水平显著降低(P<0.05),Qm、Vm水平显著升高(P<0.05),Rv、DR水平显著降低(P<0.05)。结论电针治疗能有效提高急性脑梗死患者血清VEGF、BDNF的表达水平及降低Flt-1的表达水平,可改善患者神经功能及脑血流动力学。
Objective To investigate the effects of electroacupuncture on the expressions of vascular endothelial growth factor(VEGF),VEGF receptor-1/fms-like tyrosine kinase-1(Flt-1)and brain-derived neurotrophic factor(BDNF)in patients with cerebral infarction and their clinical effects.Methods A total of 160 patients with acute cerebral infarction diagnosed and treated in the hospital were collected.Random number table method was used to divide patients into control group(80 cases)and study group(80 cases).The qRT-PCR method was used to detect the expressions of VEGF mRNA and Flt-1 mRNA.The level of serum BDNF was detected by ELISA.The clinical treatment effect,neurological deficit score and activity of daily living scale(ADL)score were compared between the two groups of patients.The levels of serum interleukin-1β(IL-1β),interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α)were detected by ELISA.Patients'cerebral hemodynamic indexes[average blood flow(Qm),average blood flow velocity(Vm),peripheral resistance(Rv),dynamic resistance(DR)]of common carotid artery were detected.Results Compared with those of the control group,the improvement rate and total effective rate of patients in the study group were significantly increased(P<0.05),and the incidence of no change and the rate of deterioration were significantly reduced(P<0.05).After treatment,the neurological deficit score was significantly reduced in both groups(P<0.05),and the ADL score was significantly increased(P<0.05),and the difference be-tween the control group and the study group was statistically significant(P<0.05).After treatment,compared with those of the control group,the expression levels of serum VEGF mRNA and BDNF in the study group were significantly increased(P<0.05),and the expression levels of Flt-1 mRNA were significantly reduced(P<0.05),the levels of hs-CRP and TNF-αwere significantly reduced(P<0.05),the levels of Qm and Vm were significantly increased(P<0.05),and the levels of Rv and DR were significantly reduced(P<0.05).Conclusion Electroacupuncture can effectively increase the expression levels of VEGF and BDNF in serum and decrease the expression level of Flt-1 in patients with acute cerebral infarction,and can improve the neurological function and cerebral hemodynamics.
作者
刘洁
张建刚
马登飞
LIU Jie;ZHANG Jiangang;MA Dengfei(Anyang People's Hospital,Anyang 455000,Henan,China)
出处
《中华中医药学刊》
CAS
北大核心
2023年第3期231-234,共4页
Chinese Archives of Traditional Chinese Medicine
基金
河南省医学科技攻关计划联合共建项目(LHGJ20191270)。
