不同部位重型脑梗死患者肠黏膜屏障功能变化研究

摘要

Objective To study the changes of intestinal mucosal barrier in patients with different area severe cerebral infarction ( brain stem infarction , hemisphere infarction ) .Methods 56 patients with different area severe cerebral infarction ( 22 was brain stem infarction and 34 was hemisphere severe cerebral infarction ) , respectively in 24h, 72h,1w ,2w after the illness, venous blood was collected , and 30 healthy subjects served as control.The serum diamine oxidase (DAO)and D-lactic acid (D-LAC) were detected in 56 patients and 30 normal controls by double antibody enzyme linked immunosorbent assay .Results Whether hemispheric infarction or brain stem infarction, patients with intestinal mucosal barrier function changes soon after illness sickness , in 24 hours,72 hours, 1 week and 2 weeks serum D-LAC and DAO levels remain high,lasted a higher level.The two groups patients showed decreasing trend after 2 weeks, but still higher than that of the control group .Conclusion Hemisphere severe infarction and brain stem infarction patients can appear mucous membrane barrier function damage after illness in 24 hours, and the damage can last 2 weeks or longer .%目的：探讨不同部位重型脑梗死（脑干梗死、半球大面积梗死）患者肠黏膜屏障变化。方法选取重型脑梗死患者共56例，（脑干梗死22例，半球大面积梗死34例），分别于患病后24h、72h、1w及2w采集空腹静脉血，同时选取同期门诊健康体检者30例作为对照，抽取空腹静脉血，采用双抗体夹心ELISA法测定血清二胺氧化酶（ DAO）、D-乳酸（ D-LAC）检测含量。结果无论半球大面积梗死还是脑干梗死，患者在患病后很快出现肠黏膜屏障功能的改变，在患病24h达较高水平，随后的72h、1w及2w血清D-LAC及DAO持续高水平，2组患者于2w后呈降低趋势，但仍高于对照组。结论无论半球大面积脑梗死还是脑干梗死，患者患病后24h内即可出现黏膜屏障功能损伤，2组患者肠黏膜屏障功能损伤可持续2w或更长时间。