急性脑梗死与血清、脑脊液IL-1α动态变化的临床研究

目的研究炎性细胞因子白细胞介素-1α(IL-1α)在脑缺血性损伤方面的作用,探讨其动态变化与脑梗死的关系。方法采用双抗体夹心酶联免疫吸附法(ELISA)测定36例脑梗死患者发病24h、72h、7d血清中IL-1α的含量变化,19例脑梗死患者发病24h、7d脑脊液中IL-1α的含量变化。并与对照组20例血清、13例脑脊液IL-1α水平进行比较。结果(1)脑梗死组血清IL-1α在发病24h开始升高,且在72h达到高峰,7d逐渐下降,虽未达到对照组水平,但亦明显低于24h和72h(P<0.05或P<0.01)。(2)脑脊液IL-1α在发病24h明显升高,7d逐渐下降,仍未达到正常对照组水平。(3)血清和脑脊液IL-1α的变化呈动态正相关关系。结论无论血清或脑脊液IL-1α的持续升高可延长脑梗死的恢复期,并且预后不好。可能与缺血半暗带不能及时恢复有关。

Clinical research on the dynamic changes of serum IL-1α and CSF IL-1α in patients with acute cerebral infarction

Objective To investigate the dynamic changes of IL-1α and its significance in patients with acute cerebral infarction.Methods ELISA was adopted to test the content change of IL-1α in the serum of 36 patients with acute cerebral infarction (ACI) and 20 cases in the healthy control group at 24 h,72 h,as well as 7 days after the attack of the disease respectively. The content change of IL-1α in the cerebrospinal fluid of 19 patients and 13 cases in control group was measured at 24h and 7days after the attack respectively.Results (1)The content of IL-1α in the serum in ACI group increased at 24 h after the attack ,reaching the peak at 72 h,7 days later,it was still higher than normal level,but lower than that at 24 h and 72 h (P<0.05 or P<0.01).(2)The content of IL-1α in the cerebrospinal fluid also elevated at 24h (P<0.01),and decreased at 7 days but was still higher than that of the normal level (P<0.01).(3)The changes of IL-1α in the serum and the cerebrospinal fluid shows a positive correlation.Conclusion Persistent increase of either serum IL-1α or cerebrospinal fluid IL-1α may prolong the convalescence of patients with acute cerebral infarction and brings out a bad prognosis,might resulting from the retarded recovery of ischemic penumbra.