吴庆建等

[摘要] 目的 研究脑梗死（CI）后神经功能缺损程度与降钙素（CT）基因相关肽（CGRP）相关指标的关系。 方法 选择2012年1月～2013年12月济宁市第一人民医院（以下简称“我院”）急诊内科CI恢复早期患者120例，据神经功能缺损程度将其分为轻、中、重型三类。所有患者均经头颅MRI确诊。同时，选择同期我院健康体检者60例作为对照。采用RT-PCR检测CGRP mRNA水平，用免疫荧光分析法检测CT水平，CGRP和血Ca2+由我院检验科负责检测。CGRP mRNA用其相对表达（RE）来表示。分析CGRP mRNA、CGRP、血Ca2+和CT与CI后神经功能缺损程度的关系。 结果 120例患者及60例健康对照者的血液中均能检测到CGRP、CGRP mRNA、CT。CI后恢复早期神经功能缺损程度与CGRP mRNA（RE）及血清CT均呈正相关（r = 0.508、0.510，P < 0.01、P < 0.05）。CGRP的变化趋势与CGRP mRNA（RE）一致（P = 0.000）。研究初期CGRP mRNA（RE）高表达患者均为重型神经功能缺损者，在6个月内恢复良好，逐渐向中型和轻型神经功能缺损转变。 结论 CGRP相关指标CGRP mRNA、Ca2+、CT均能反映CI后神经功能缺损程度及预后。CI后恢复早期神经功能缺损程度与CGRP mRNA（RE）水平呈正相关，CGRP mRNA（RE）与CT呈正相关。CGRP mRNA高值（RE）一般存在于重型神经功能缺损的患者之中，值越高，患者预后越好。

[关键词] 脑梗死；神经功能缺损程度；降钙素；降钙素基因相关肽

[中图分类号] R743.33 [文献标识码] A [文章编号] 1673-7210（2015）02（b）-0012-06

[Abstract] Objective To research the relationship between nerve function defect degree and calcitonin （CT） gene-related peptide （CGRP） related indicators after cerebral infarction （CI）. Methods 120 early CI recover patients from January 2012 to December 2013 in Emergency Internal Medicine of the First People's Hospital of Jining City （“our hospital” for short）. According to the degree of nerve function defect， they were divided into light， medium and severe categories. All of the patients were diagnosed with cranial MRI. While， 60 cases of healthy persons in the same period in our hospital were included as control group in this research. Through clinical and laboratory data， the relationships between CGRP mRNA， CGRP， blood calcium （Ca2+）， CT and nerve function defect degree after CI were studied. CGRP mRNA was measured by RT-PCR. CGRP and Ca2+ were measured in the Department of Laboratory in our Hospital. CT was measured through immunofluorescence analysis method. CGRP mRNA was expressed with its relative expression （RE）. Results CGRP， CGRP mRNA and CT were detected both in the 120 patients and 60 healthy persons. Nerve function defect degree was positive related with CGRP mRNA （RE） and serum CT （r = 0.508， 0.510； P < 0.01， P < 0.05）， during early CI recovery period. The change trends of CGRP and CGRP mRNA （RE） were consistent （P = 0.000）. At the beginning of this study， patients with high expressed CGRP mRNA （RE） were all combined with server nerve function defect， while restored well 6 months later， gradually shifting to the medium and light nerve function defect. Conclusion CGRP and related indicators CGRP mRNA， Ca2+， CT can reflect the nerve function defect degree and prognosis after CI. Early CI recover period， the nerve function defect degree is positive related with CGRP mRNA （RE）， CGRP mRNA （RE） is positive related with CT. High value of CGRP mRNA （RE） generally exists in patients with server nerve function defect， the higher the CGRP mRNA value （RE）， the better the prognosis of patients.

[Key words] Cerebral infarction； Nerve function defect degree； Calcitonin； Calcitonin gene-related peptide

脑梗死（cerebral infarction，CI）是我国中老年人的常见病。发病原因是脑部血供障碍使局部脑组织发生不可逆性损害，导致脑组织缺血缺氧性坏死[1]。降钙素（CT）基因相关肽（calcitonin gene-related peptide，CGRP）是一种生物活性多肽，有α-CGRP和β-CGRP两种，能够扩张脑血管、保护和恢复损伤的神经元和介导神经免疫系统调节的功能，对中枢神经系统产生多种影响。CGRP mRNA是细胞核CGRP DNA转录产生的核糖核苷酸链，其在细胞的核糖体内翻译生成CGRP。由于CGRP对CI患者诸多方面有利，笔者对CI后神经功能缺损程度与CGRP相关指标的关系进行前瞻性观察性研究，现报道如下：

1 资料与方法

1.1 一般资料

选择2012年1月～2013年12月在济宁市第一人民医院（以下简称“我院”）急诊内科住院的CI恢复患者120例，其中男72例，女48例，年龄42～75岁，平均（57.2±4.6）岁。……