| Stroke is the most common serious life - threatening neurological disorder. It is the leading cause of adult disability and the third leading cause of death. Intracerebral hemorrhage is one of the common stroke, so it is necessary and important for the study of intracerebral hemorrhage. The insulin - like growth factor -1 (IGF -1) is polypep-tide growth factor that mediate growth hormone and is synthesized and secreted by numerous cell types. IGF - 1 is multifunction peptide essential for normal growth and development. IGF - 1 is also present in the brain and is involved in brain development. After experimental hy-poxic injury, there is an increased expression of IGF - 1 mRNAs and protein in regions with neuronal loss. In vitro studies have indicated that IGF - 1 is a potent nonselective neurotrophic agent. Recently IGF -1 has been recognized as an important mediator in wound healing and tissue repair. The secretory dynamics of IGF -1 hi human cerebral hemorrhage have not yet been investigated. The present study was conducted to evaluate IGF - 1 serum levels in patients with cerebral hemorrhage and to correlate IGF - 1 levels to the extent of cerebral hemorrhage.Subjects and MethodPersons with①diabetes mellitus, ②concomitant cardiac, renal, hepatic, or cancerous disease, ③recent history of TIA or head trauma, ④receiving medication known to suppress the somatotrophic hormone axis steroids, ⑤malnutrition were excluded from the study. Twenty - four patients with acute intracerebral hemorrhage ( 14 men and 10 women) aged 46 to 70 years (mean,58 ±7.9years) and sixteen age -matched healthy controls (8 men and 8 women)aged 42 to 66 years (mean,54 ±6. 7years)were studied. The patients were classified to there groups according to the diameter of the hemorrhagic area as measured on CT scan: S group( d < 1. 5cm) , M group( 1. 5cm< d <5.0cm) ,L group (d>5.0cm).Serum IGF - 1 levels were measured sequentially in patients, who were admitted to the hospital within 24 hours after onset of symptoms. Blood sample was drawn by venipuncture within the first 24 hours after stroke and again 4 and 10 days thereafter. Fasting blood samples were taken and serum was separated by centrifugation and quickly frozen in -70℃. The control' s fasting blood samples were taken, serum was separated and stored at - 70℃ until assayed. The IGF -1 levels were determined by ELISA. The levels of white blood cell and fasting blood glucose were determined, which is used for routine measurements in hospital. The clinical examinations were scored according to the CSS on days 1, 4 and 10 after stroke.Results are expressed as mean ± SD. Statistical analysis was performed by t test, q test and linear regression and correlation.ResultsThe serum levels of IGF - 1 in patients were significantly lower than those of the control group at any time point( p < 0.01) . The values of those patients in L group were the lowest among all stroke subtypes , and the values of those patients in S group were the highest. No differences were detected within three times measurement during the clinical course. The levels of white blood cell in patients were significantly higher than those of the controls (P <0.01) , and the results of fasting blood glucose in patients were significantly higher than those of the controls ( P < 0. 05 ). The IGF - 1 levels were inversely related to the results of CSS in patients (r = - 0. 542).DiscussionWe found the serum levels of IGF - 1 decreased in patients with acute stroke over a period of 10 days after onset of symptoms, and the decline was similar in all stroke subtypes. A clear trend to lower IGF -1 levels depending on the size of hemorrhage was obvious.Guan et al suggested that IGF -1 serves as an endogenously protective mechanism to limit injury. IGF - 1 has been shown to interfere with apoptosis in nonneuronal and neuronal cells. Although the mechanism for the reduction of serum IGF - 1 levels remains obscure. Several explanations are possible.It is well known that IGF - 1 are expressed in th...
|
PDF Full Text Request