前列地尔对急性脑梗死患者血清β淀粉样蛋白水平及神经功能的影响

摘要

目的：探讨前列地尔治疗对急性脑梗死患者血清β淀粉样蛋白（1－40）、（1－42）[Aβ（1－40）、Aβ（1－42）]水平及神经功能的影响。方法选择急性脑梗死患者84例，分为前列地尔组及对照组各42例，前列地尔组给予静脉滴注前列地尔10μg／d，每日1次，共治疗14天；对照组不使用前列地尔，其他治疗相同。两组患者分别于治疗前、治疗后14天和28天测定静脉血 Aβ（1－40）、Aβ（1－42）水平并评价神经功能缺损程度。结果治疗前两组间血清 Aβ（1－40）、Aβ（1－42）及 Aβ（1－40）／Aβ（1－42）比值差异无统计学意义（P ＞0．05）。治疗后14天、28天，前列地尔组 Aβ（1－40）及 Aβ（1－40）／Aβ（1β－42）比值逐步降低（P ＜0．001），Aβ（1－42）于治疗后14天升高（P ＜0．05）。对照组 Aβ（1－40）和 Aβ（1－42）水平无显著改变（P ＞0．05）。两组神经功能缺损情况均较治疗前明显改善，与对照组相比，治疗组改善更明显（P ＜0．01）。结论前列地尔可以降低急性脑梗死后血清 Aβ（1－40）水平，降低血清 Aβ（1－40）／Aβ（1－42）比值。对急性脑梗死神经功能缺损有更好的改善作用。%Objective To investigate the effects of alprostadil on serum levels of A β1-40 and Aβ1-42 and neurological impair-ment in patients with acute cerebral infarction .Methods Eighty-four patients with acute cerebral infarction were enrolled within 48 h of onset.The enrolled patients were randomly divided into alprostadil and control groups .Alprostadil was infused at a dose of 10 μg, once daily for 14 days while the control group received similar treatment except alprostadil infusion .Blood samples were collected before treatment and 14 and 28 days after treatment to measure changes of serum levels of A β1-40 and Aβ1-42.Meanwhile,the degree of neu-rological impairment was estimated.Results Before the treatment,there was no significant difference in serum levels of A β(1-40) and Aβ(1-42) and Aβ(1-40) /Aβ(1-42) between the two groups.However,after 14 days of the treatment,serum levels of Aβ1-40 were gradually decreased(P <0.001)while serum levels of Aβ1-42 were increased(P <0.05)in the alprostadil group.In the control group, there were no significant changes in serum levels of A β1-40 and Aβ1-42 after the treatment.After 14 and 28 days of the treatment,the ratio was gradually decreased in the alprostadil group .In the control group the ratio was increased on the day 14 after treatment and then decreased but still higher than that before treatment .The neurological impairment of the two groups was improved .Compared to the con-trol group,the improvement in the alprostadil group was more significant (P <0.01).Conclusion Alprostadil can decrease levels of serum Aβ1-40 and ratio of Aβ1-40 /Aβ1-42 in patients with acute cerebral infarction that may has a better improvement for neurologi -cal impairment caused by acute cerebral infarction .