血漿Thrombomodulin蛋白與血漿Tau蛋白濃度對於評估缺血性中風之相關性研究

Study of The combination of plasma Thrombomodulin and plasma Tau levels as a diagnostic value for Ischemic Stroke

曾立德(Li-Te Tseng)

指導教授 ： 鄭鈞文

中山醫學大學/醫學院/生化暨生物科技研究所/碩士(2012年)

摘要

缺血性腦中風即腦血管阻塞或循環不良造成的症狀，絕大部為急性發作。引起缺血性中風兩個原因為腦血栓(cerebral thrombosis)及腦栓塞(cerebral embolism) ，若能在早期給予處置，可減少中風的嚴重程度。中風除了臨床症狀的觀察，也需要透過多種臨床測試以協助診斷，例如一些神經系統評分檢查（NIHSS），CT掃描或核磁共振成像等成像技術協助，但目前仍沒有高專一性的血液診斷項目。
2000年的研究，採檢中風發作3至24小時血清。使用NIHSS評分，並利用神經元相關蛋白NSE、S-100β、MBP、Thrombo- modulin(TM)進行分析，NSE、S-100β、MBP已確定與神經元損傷及缺血性中風有相關，然而TM則尚未有結論。已知Tau蛋白在神經病變疾病，如阿滋海默症（AD)，由於Tau結構改變，造成微管糾結、瓦解，造成神經元細胞死亡，傳導異常。 本篇研究，使用ELISA(Enzyme-linked immunosorbent assay)方法分析了血漿TM蛋白與Tau蛋白，結果CVA組之TM濃度平均值為9.21 (±2.8)ng/mL，對照4.83ng/mL 0.94)，顯示中風患者的TM濃度顯著高於正常人(p=0.01)。而Tau蛋白濃度則沒有顯著差異(p=0.1)。

關鍵字

缺血性中風 ； 阿滋海默症 ； 神經元損傷

並列摘要

Ischemic stroke, known as cerebral vascular obstruction or poor circulation, is mostly acute. Two main causes for ischemic stroke are cerebral thrombosis and cerebral embolism. Earlier treatment can reduce the severity of the stroke.
Diagnosis of stroke not only can be identified through clinical observations but also several clinic examinations such as NIHSS Score, CT scan, or NMRI techniques. However, there is a lack of high specificity blood examination.
Recent research suggests to collect blood serum between 3 to 24 hours after stroke. Through NIHSS analysis, using neuron-associated protein NSE, S-100β, MBP, and Thrombomodulin (TM). NSE, S-100β, and MBP has been confirmed it is relevant to the neuronal damage ischemic stroke. However, findings regard Thrombomodulin are inconclusive.
Tau protein plays an important role in neural disease such as Alzheimer’s disease (AD). The structural change of Tau causes the interwined microtubule; and neural damages and eventually its failure to function.
This the present study, the Thromomodulin protein and Tau protein were analyzed. The findings indicate the stroke patients’ TM concentration are higher than the non-stork patient (p=0.01) but Tau concentration are not significant different (p=0.1).

並列關鍵字

ELISA ； Thrombomodulin ； Tau ； CVA ； AD

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