目的 探讨血清神经肽Y(neuropeptide Y,NPY)与颈性眩晕患者严重程度的相关性及刃针治疗效果。方法 选取颈性眩晕患者88例,选取同期来院体检的健康人86例。采用酶联免疫吸附试验ELISA检测血清NPY与血清降钙素基因相关肽(calcitonin gene-related peptide, CGRP)的水平,采用模拟视觉评分法对眩晕的严重程度进行分级,同时采用经颅多谱勒超声仪(TCD)测量基底动脉和左右椎动脉的平均血流量和平均血流速度,对比患者刃针治疗前后各指标的变化情况。结果 颈性眩晕患者血清NPY水平高于健康对照组[(509.7±80.8) pg/ml vs (433.8±66.1) pg/ml, P<0.001];血清NPY水平在重度组显著高于中度组和轻度组,中度组显著高于轻度组;血清NPY水平与视觉模拟评分之间呈正相关性(r=0.421,P<0.001),与平均血流量(r=-0.361,P<0.001)、平均血流速度(r=-0.472,P<0.001)及血清CGRP水平(r=-0.380,P<0.001)呈负相关,各指标在刃针治疗后均得到改善(P<0.05)。结论 血清NPY水平与颈性眩晕患者疾病严重程度呈正相关,刃针治疗颈性眩晕的机制有可能与下调NPY有关。
Abstract
Objective To investigate the correlations between serum neuropeptide Y (NPY) levels and disease severity in patients with cervical vertigo and the efficacy of the blade needle.Methods Eighty-eight cervical vertigo patients diagnosed in our hospital were enrolled, while another 86 healthy people were selected as controls. Serum NPY and serum calcitonin gene-related peptide (CGRP) levels were measured by enzyme-linked immunosorbent assay (ELISA). The severity of vertigo was graded by visual analog scores. Cranial Doppler ultrasound (TCD) was used to measure the mean blood flow and mean blood flow velocity of the base artery as well as the left and right vertebral arteries. Finally, the changes of indicators before and after the blade needle treatment were compared.Results Serum NPY levels were significantly higher in patients with cervical vertigo than in healthy controls[(509.7±80.8) pg/ml vs (433.8±66.1) pg/ml, P<0.001], and in the severe group than in the moderate and mild groups. In addition, these levels were markedly elevated in the moderate group than in the mild group. There was a strong positive correlation between the serum NPY level and the visual analog score(r=0.421,P<0.001). However, serum NPY levels were negatively correlated with mean blood flow(r=-0.361,P<0.001) and mean blood flow velocity(r=-0.472,P<0.001) and serum CGRP levels(r=-0.380,P<0.001). All indicators were improved after blade needle treatment (P<0.05).Conclusions Serum NPY levels are positively correlated with disease severity in cervical vertigo patients. The mechanism may be associated with down-regulation of NPY.
关键词
神经肽Y /
颈性眩晕 /
严重程度 /
刃针
Key words
neuropeptide Y /
cervical vertigo /
disease severity /
blade needle
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] West N, Hansen S, Moller M N, et al. Repositioning chairs in benign paroxysmal positional vertigo: implications and clinical outcome[J]. Eur Arch Otorhinolaryngol,2016,273(3): 573-580.
[2] Li, Y, Peng, B. Pathogenesis, diagnosis, and treatment of cervical vertigo[J]. Pain Physician,2015, 18(4): E583-E595.
[3] Habler H J, Stegmann J U, Timmermann L, et al. Functional evidence for the differential control of superficial and deep blood vessels by sympathetic vasoconstrictor and primary afferent vasodilator fibres in rat hairless skin[J]. Exp Brain Res,1998,118(2):230-234.
[4] Chronwall B M, Zukowska Z. Neuropeptide Y, ubiquitous and elusive[J]. Peptides, 2004,25(3):359-63.
[5] Pheng L H, Regoli D. Receptors for NPY in peripheral tissues bioassays[J].Life Sci,2000,67(8):847-62.
[6] Jacques D, Abdel-Samad D. Neuropeptide Y (NPY) and NPY receptors in the cardiovascular system: implication in the regulation of intracellular calcium[J].Can J Physiol Pharmacol, 2007,85(1):43-53.
[7] Kuo L E, Abe K, Zukowska Z. Stress, NPY and vascular remodeling: implications for stress-related diseases[J].Peptides, 2007,28(2):435-440.
[8] 姜布平,赵爱英.毫针、刃针联合治疗颈性眩晕800例[J].辽宁中医杂志,2013,40(11):2347-2348
[9] 王慧敏,曾浩彬,陈文治,等.刃针松解术治疗颈性眩晕[J].广东医学,2012,33(3):366-368.
[10] 国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:184-189.
[11] Zukowska Z, Pons J, Lee E W, et al. Neuropeptide Y: a new mediator linking sympathetic nerves, blood vessels and immune system?[J]. Can J Physiol Pharmacol, 2003, 81(2): 89-94.
[12] Zukowska-Grojec Z, Karwatowska-Prokopczuk E, Rose W, et al. Neuropeptide Y: a novel angiogenic factor from the sympathetic nerves and endothelium[J]. Circ Res, 1998(2),83: 187-195.
[13] Kitlinska J, Lee E W, Movafagh S, et al. Neuropeptide Y-induced angiogenesis in aging[J]. Peptides, 2002,23(1): 71-77.
[14] Sheng Y, Zhu L. The crosstalk between autonomic nervous system and blood vessels[J].Int J Physiol Pathophysiol Pharmacol, 2018,10(1):17-28.
基金
广西壮族自治区教育厅高校中青年教师基础能力提升项目(J17106)
PDF(657 KB)
