无症状脑梗死的临床意义

无症状脑梗死 (ｓｉｌｅｎｔｂｒａｉｎｉｎｆａｒｃｔｉｏｎ ,ＳＢＩ)是指无卒中病史 ,无明确神经系统定位体征 ,由影像学或尸检发现的梗死灶 ,包括 2种情况 :一是无卒中史人群中存在的脑梗死灶 ;二是卒中患者中存在的不能解释其症状体征的梗死灶。“无症状”并非指机体处于无病痛的良好状态。脑梗死的机制是各种原因引起的脑血管闭塞 ,导致脑组织缺血缺氧坏死 ,因此绝大多数患者都能找到缺血的征兆。所谓的“无症状”主要是指无定位体征 ,并不排除如头痛、头昏、智能减退等一般症状。同时 ,还可通过这些蛛丝马迹及早发现患者脑缺血的情况…     

辛伐他汀对急性脑梗死患者血清CRP及IL-6水平的影响

目的探讨辛伐他汀对急性脑梗死患者血清C-反应蛋白（CRP）及白细胞介素-6（IL-6）水平的影响。方法将70例急性脑梗死患者应用随机数字表法随机分为观察组和对照组各35例。两组患者均予肠溶阿司匹林口服,皮下注射低分子肝素钙,静脉注射奥扎格雷钠、胞二磷胆碱、6％羟乙基淀粉等常规对症治疗。观察组在此基础上加用辛伐他汀10mg,1次／d,晚睡前口服,连用14d。比较两组患者的临床疗效以及治疗前后CRP、IL-6水平的变化。结果观察组患者治疗总有效率（91．4％）明显高于对照组（71．4％）,差异有统计学意义（P〈0．05）。治疗后两组患者CIIP、IL-6水平均较治疗前明显降低（P均〈0．05）;与对照组比较观察组降幅更显著（P〈0．05）。结论合用辛伐他汀治疗急性脑梗死可以提高临床疗效,辛伐他汀可能对CRP、IL-6的生成具有抑制作用。     

无症状脑梗死患者同型半胱氨酸的临床研究

目的 探讨血浆同型半胱氨酸(Hcy)与无症状脑梗死(SBI)的相关性.方法 收集研究对象213例,其中SBI患者77例,非SBI患者136例,检测患者空腹12小时后静脉血空腹血糖(FBG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)以及Hcy水平等指标.结果 SBI的患病率为36.2％.年龄、高血压病史、糖尿病史、LDL-C及Hcy升高与无症状脑梗死发生存在相关性,比值比(OR)[95％可信区间(CI)]分别为1.301(1.021 ～3.676;P ＜0.05)、1.599(1.022～3.886;P＜0.01)、1.245 (1.101～2.651;P＜0.01)、1.518(1.017～2.573;P ＜0.05)、1.100(1.032～1.173;P＜0.01).结论 Hcy是SBI的独立危险因素,对≥60岁老年人群检测Hcy,可以识别SBI的高危人群.     

IL-6 levels in acute and post myocardial infarction: their relation to CRP levels, infarction size, left ventricular systolic function, and heart failure

BACKGROUND: Inflammatory mechanisms in heart disease are of great interest. The proinflammatory cytokine interleukin (IL) 6 has been linked to increased morbidity in unstable angina pectoris and depressed myocardial function in heart failure (HF). METHODS: We studied the relation of IL-6 levels to C-reactive protein (CRP), infarction size, left ventricular function, and HF in acute myocardial infarction (MI) and after hospital discharge in 31 consecutive patients (19 males, mean age 69+/-13 years). Blood sampling for IL-6 was performed on admittance, four times on day 1, twice on day 2, and once daily on days 3-5, and 6 and 12 weeks later. Clinical signs of HF were evaluated daily during hospitalization and after 6 and 12 weeks. Echocardiography was performed on day 3 and at 6 weeks. RESULTS: IL-6 showed a curved time course with elevated levels already on admittance (mean+/-S.D. 19.3+/-26.9 ng/l), thereafter increasing to a peak on days 1 and 2 (maximum 68.5+/-152.9 ng/l), and then declining rapidly to lower, although not normalized, levels during hospitalization and at 6 and 12 weeks. CRP showed a similar time pattern, but with a later peak and a seemingly less rapid decline in levels. Mean levels of IL-6 and CRP on days 1-5 correlated highly (r=0.794, p<0.0001). IL-6 and infarction size did not correlate. HF during hospitalization and at 6 weeks was not related to IL-6; however, patients with HF at 12 weeks had higher IL-6 levels, both at 6 and 12 weeks. Patients on ACE inhibitors or diuretics at discharge had higher IL-6 levels at 6 weeks. IL-6 during hospitalization was not related to LVF; yet, patients with depressed LVF in the hospital and at 6 weeks had higher IL-6 levels at 6 and 12 weeks. CONCLUSIONS: IL-6 in acute MI shows a curved time course and is highly correlated to CRP. It peaks on days 1 and 2 and remains elevated even after 12 weeks. Increased IL-6 levels after hospital discharge are associated with HF and depressed LVF. Whether anti-inflammatory agents will influence left ventricular dysfunction and outcome postacute MI has yet to be determined.     

冠心病与无症状性脑梗死相关性临床研究

目的探讨无症状性脑梗死(SBI)与冠心病的相关性.方法对52例冠心病病人作选择性冠状动脉造影和Gensini评分,以评定冠状动脉硬化的程度.并于冠状动脉造影后一周进行头颅的CT扫描及颈动脉超声显像检查,然后分析两病的相关性.结果(1)头颅CT查出SBI患者14例(26.9%);(2)14例SBI病人中11例(78.5%)伴有冠状动脉左前降支狭窄;(3)与无SBI者比较,14例SBI者的年龄(65.57±2.42岁)显著增大(P＜0.001);冠状动脉造影评分(1.928±0.286)、Gensini评分(35.86±5.13)均显著升高(P均＜0.005);(4)冠状动脉造影评分与SBI阳性率的相关系数为0.892,Gensini评分与SBI病灶数的相关系数为0.957.结论冠心病与无症状性脑梗死呈显著正相关关系,老年冠心病人尤其是冠状动脉左前降支狭窄者易并发无症状性脑梗死.     

In-hospital and long-term prognostic value of fibrinogen, CRP, and IL-6 levels in patients with acute myocardial infarction treated with thrombolysis

Plasma fibrinogen, C-reactive protein (CRP), and interleukin-6 (IL-6) levels in patients with acute myocardial infarction (AMI) receiving thrombolysis have been related to prognosis. The aim of this study was to investigate the time course of plasma fibrinogen, CRP, and IL-6 levels during the in-hospital phase in patients with AMI receiving thrombolysis, and their relationship to in-hospital and prognosis after 12-months follow-up. In 40 patients presenting with AMI within 6 hours of symptom onset and treated with thrombolysis, plasma fibrinogen, CRP, and IL-6 levels were measured on admission and after 6, 12, 24, 48, and 72 hours; 7 days; and 6 months. Patients with other diseases that can alter fibrinogen, CRP, or IL-6 levels were excluded. Patients had a clinical follow-up at 6 and 12 months, and the following cardiac events were recorded: cardiac death, recurrent angina, recurrent AMI, and heart failure. Plasma fibrinogen concentrations decreased significantly (p <0.01 vs admission levels) at 12 hours (425 +/-94 vs 322 +/-132 mg/dL), started to increase at 24 hours, reached peak value at 72 hours (602 +/-209 mg/dL), remained elevated at 7 days, and were back to admission levels at 6 months (375 +/-79 mg/dL). CRP levels increased significantly at 12 hours (0.73 +/-0.43 vs 0.23 +/-0.11 mg/dL, p <0.01), reached peak value at 72 hours (7.66 +/-3.28 mg/dL), decreased significantly on day 7 (2.32 +/-1.17 mg/dL), and at 6 months were within normal limits (0.49 +/-0.29 mg/dL). IL-6 levels increased significantly at 6 hours (14.03 +/-8.13 vs 6.37 +/-3.88 pg/mL, p <0.05), reached peak value at 24 hours (59.49 +/-23.57 pg/mL), started to decrease at 48 hours, and at 6 months were within normal limits (2.25 +/-1.24 pg/mL). During the in-hospital phase 33 patients had an uneventful course and 7 patients had complications (3 post-AMI angina; 4 heart failure). During the 12-month follow-up period 28 patients had an uneventful course, and 12 patients had complications (1 cardiac death, 5 recurrent angina, 2 recurrent AMI, and 4 heart failure). Regarding the in-hospital prognosis, fibrinogen, CRP, and IL-6 levels were significantly higher (p <0.05) in patients with complications from 48 to 72 hours, from 12 hours until day 7, and from 6 hours until day 7, respectively. During the 12-month follow-up period fibrinogen, CRP, and IL-6 levels were significantly higher in patients with complications (at 48, 24, and 24 hours, respectively) only in the subgroup of patients who had complications within the first 6 months following AMI. Multivariate analysis showed that CRP at 48 hours was the most important factor related to in-hospital prognosis (p = 0.02), and ejection fraction followed by CRP at 24 hours (p = 0.02) to 6-month prognosis (p = 0.018). Fibrinogen, CRP, and IL-6 levels alter in patients with AMI receiving thrombolysis, and are related both to in-hospital and to 6-month follow-up prognosis.     

COPD患者CRP、IL-6、IL-10水平与心血管事件的相关性

目的探讨COPD患者CRP、IL-6、IL-10水平与其心血管事件的相关性。方法选择2013年5月至2014年2月我院收治的60例伴有心血管疾病的COPD老年患者作为观察组,并选择同期60例无合并心血管疾病的COPD老年患者作为对照组。通过放免法检测两组患者体内CRP、IL-6、IL-10水平观察其与患者心血管事件的相关性。结果观察组CRP、IL-6分别为(16.4±2.6)ng/L和(12.8±0.6)mg/L,显著高于对照组,差异具有统计学意义(P0.05);观察组IL-10水平为(8.4±1.2)ng/L,显著低于对照组,差异具有统计学意义(P0.05);随着病情程度加重,CRP、IL-6水平逐渐增加,重度患者含量明显高于轻度患者(P0.05);IL-10水平随着程度加重而降低,重度患者明显低于轻度(P0.05)。结论合并心血管疾病的COPD患者体内炎症反应明显,炎症因子CRP、IL-6升高,抗炎因子IL-10降低,因此检测细胞因子水平在一定程度上可反映病情程度。     

C-反应蛋白白细胞介素-6和肿瘤坏死因子-α在冠心病中的变化

目的 :探讨炎症标记物与冠心病的关系及临床意义。方法 :选择健康体检者 (正常对照组 ) 30例、稳定型心绞痛 (SAP组 )患者 2 0例、不稳定型心绞痛 (UAP)患者 2 5例和急性心肌梗死 (AMI)患者 30例 ,分别测定血清中C 反应蛋白 (CRP)、白细胞介素 6 (IL 6 )和肿瘤坏死因子 α(TNF α)的浓度。结果 :①SAP、UAP、AMI与正常对照组比较 ,血清中CRP、IL 6、TNF α均显著增高 ,差异均具有统计学意义 (均P <0 .0 1) ;②UAP与SAP比较 ,血清中CRP、TNF α均显著增高 (P <0 .0 1) ,但与IL 6比较差异无统计学意义 ;③AMI与SAP比较 ,血清中CRP、IL 6、TNF α均显著增高 ,差异均具有统计学意义 (P <0 .0 1) ;④AMI与UAP比较 ,血清中CRP、IL 6、TNF α均显著增高 ,差异均具有统计学意义 (P <0 .0 5 ) ;⑤血清中CRP、IL 6、TNF α在AMI发病的 72h以内有明显动态变化。结论 :炎症参与了冠心病的发病过程 ,血清中炎症因子水平的高低与冠心病的严重程度有关 ,AMI时炎症因子的动态演变可以作为病情稳定性的指标 ,对判断病情和预后具有临床价值。     

Association between PRKCH gene polymorphisms and subcortical silent brain infarction

Recently, a large-scale genetic epidemiological study has shown significant association of single nucleotide polymorphisms (SNPs) in the protein kinase C η (PRKCH) gene with cerebral infarction, particularly, with lacunar infarction. To extend the findings, we tested association of two SNPs previously reported – rs3783799 and rs2230500 – in PRKCH with silent lacunar infarction (SLI), which has drawn substantial attention in the aging societies. Disease association was tested in the case–control study design. Subjects with and without SLI were recruited from people who underwent a health-screening examination including brain MRI. Two SNPs were genotyped and proven to be in complete linkage disequilibrium (D′ = 1.00, r² = 1.00) and thus showed comparable results of disease association, which were reproduced in two panels collected independently. In the entire population involving 295 cases and 497 controls, two SNPs remained to be significantly associated with SLI under a dominant model even after adjustment for confounding factors such as hypertension (e.g., genetic effects of rs2230500, P = 0.0026 for AA + AG vs. GG, adjusted odds ratio = 1.27; 95% CI, 1.09–1.48). As the two SNPs appear to be common only in Asian people, further replication study is warranted in the other Asian populations as well as the Japanese.     

颈内动脉狭窄与无症状性脑梗死的关系

目的探讨一侧颈内动脉狭窄与无症状性脑梗死(silent brain infarction,SBI)的关系。方法选择2016年4月～2017年8月辽宁省人民医院神经内科住院的患者111例,根据头颅MRI结果及临床表现分为SBI组51例和非SBI组60例(症状性脑梗死58例及无脑梗死2例)。比较2组一般临床资料,分析SBI组双侧大脑半球的影像资料。结果 SBI组同型半胱氨酸水平明显低于非SBI组[14. 91(12. 89,20. 35)μmol/L vs 18. 06(14. 20,24. 70)μmol/L,P 0. 05)]。颈内动脉狭窄侧皮质下脑白质高信号(WMH)和脑室周围WMH与对侧比较,均无明显差异,但SBI组颈内动脉狭窄侧腔隙性脑梗死发生率明显多于对侧(58. 8%vs 45. 1%,P=0. 039)。对白质进一步评分后,颈内动脉狭窄侧皮质下WMH评分和脑室周围WMH评分明显高于对侧,差异有统计学意义(P 0. 05)。logistic回归分析显示,颈内动脉狭窄侧脑室周围WMH评分明显高于对侧WMH评分(OR=0. 496,95%CI:0. 248～0.994,P=0. 048)。结论颈内动脉狭窄与SBI有密切的关系,颈内动脉狭窄增加了前循环腔隙性脑梗死发生率,颈内动脉狭窄同侧皮质下和脑室周围WMH重于对侧。     

急症PCI对急性心肌梗死患者IL-6、CRP和SAA的影响

目的观察急性心肌梗死患者中血清炎性介质C反应蛋白(CRP)、淀粉样蛋白A(SAA)和白介素．6(IL-6)水平的变化以及PCI对炎性介质的影响。方法用酶联免疫吸附法(ELISA)检测了32例急性心肌梗死患者血清CRP、SAA、IL-6水平。其中行PCI手术14例患者，18例患者未行介入治疗，比较两组各项指标。结果AMI患者血清中的CRP，SAA发病后逐渐升高，持续到3～5d。IL-6在24h左右为最高，3～5d已下降。AMI发病早期IL-6与心肌酶呈正相关。AMI患者中介入治疗组术后血清IL-6水平较非介入治疗组高。结论AMI患者血清中炎性标志物早期即可升高并持续3～5d。IL-6与心肌损伤程度正相关。介入治疗可导致炎症反应。     

老年人群阻塞性睡眠呼吸暂停与无症状脑梗死的相关性

目的：探讨老年人群阻塞性睡眠呼吸暂停综合征（obstructivesleepapneasyndrome, OSAS）与无症状脑梗死（silent brain infarction, SBI ）的相关性。方法筛查1658名60岁以上北京和青岛老年受试者,利用多导睡眠监测仪（polysomnography, PSG ）进行OSAS诊断和分级,利用MRI检查诊断SBI。结果在所有老年受试者中,OSAS 患病率为32.1％,SBI患病率为22.4％。不同严重程度的O S AS患者与对照组合并高血压及糖尿病的患者构成比以及睡眠呼吸暂停低通气指数（apnea-hypopnea index, AHI ）、氧减指数（oxygen desaturation index, ODI ）、平均血氧饱和度和最低血氧饱和度存在显著性统计学差异。随着OSAS严重程度的增高,SBI发生率显著增高,非OSAS 患者以及轻度、中度和重度OSAS患者的SBI发生率分别为13.2％、30.5％、43.5％和68.8％,组间存在显著性统计学差异（χ2=13.365,P=0.004）。多变量logistic回归分析显示,高血压[优势比（odds ratio, OR）2.254,95％可信区间（confidence interval, CI）1.325~8.347;P=0.002]、糖尿病（OR 1.893,95％CI 1.471~8.432;P=0.003）和AHI≥15次/h （ OR 3.106,95％CI 1.583~12.571;P<0.001）为老年人群存在SBI的独立危险因素。结论60岁以上老年人群的OSAS发生率较高,OSAS 患者的SBI发生率显著高于非OSAS患者,而且随着OSAS 的加重呈递增趋势。中到重度OSAS为老年人群S BI的独立危险因素。     

CD64、CRP、IL-6在儿科感染性疾病中的诊断价值分析

目的探讨中性粒细胞表面标志物CD64、CRP、IL-6在儿科感染性疾病中的应用价值。方法将2007年10月～2011年10月儿科病房（包括NICU住院）住院患儿116例,分为重症感染组（49例）;一般感染组（36例）;非感染组（31例）。3组进行CD64、CRP、IL-6水平测定和比较。结果重症感染组CD64为（6262.24±3776.43）分子数/细胞,感染组为（3727.24±1276.32）分子数/细胞,非感染组为（2176.19±946.32）分子数/细胞,重症感染组CD64水平明显高于其他两组,3组间CD64值差异有极显著意义（P〈0.01）。CD64诊断感染的最佳临界值为2587分子数/细胞,其诊断重症感染的敏感度为89.21%,特异度为78.35%;对所有感染的诊断敏感度为67.51%,特异度为82.45%。结论细菌感染时CD64水平明显升高,全身性细菌感染时升高尤为明显,与CRP、IL-6相比诊断优越性更明显,特别对重症感染患儿诊断更有价值,可以作为早期诊断儿科感染性疾病的实验室依据。     

IL-6、CRP和TNF-α水平与阻塞性睡眠呼吸暂停低通气综合征的相关性研究

目的 探讨IL-6、C反应蛋白(CRP)和肿瘤坏死因子-α(TNF-α)水平与OSAHS的相关性.方法 选取2012年3月至2014年8月在成都市第五人民医院就诊的OSAHS患者72例,根据呼吸暂停低通气指数(AHI)分为轻度OSAHS组、中度OSAHS组和重度OSAHS组,每组24例,另选同期在成都市第五人民医院进行体检的健康者24例作为对照组.使用PSG-HOLTER多导睡眠呼吸监测记录分析系统记录各组患者睡眠呼吸监测指标,并对各组患者IL-6、CRP和TNF-α水平进行检查,分析各参数水平与OSAHS的相关性.结果 轻度、中度、重度OSAHS组患者AHI高于对照组(P＜0.05),平均SaO2和最低SaO2小于对照组(P＜0.05);轻度、中度OSAHS组患者AHI、平均SaO2和最低SaO2与中度OSAHS组和重度OSAHS组比较,差异有统计学意义(P＜0.05);轻度、中度、重度OSAHS组患者IL-6、CRP和TNF-α水平高于对照组(P＜0.05);轻度、中度OSAHS组患者IL-6、CRP和TNF-α水平和重度OSAHS组比较,差异有统计学意义(P＜0.05);IL-6、CRP和TNF-α水平与AHI呈正相关,与平均SaO2和最低SaO2呈负相关,相关系数分别为r=0.673,0.573,0.669,-0.542,-0.631,-0.603,-0.542,-0.504和-0.583,P＜0.05.结论 OSAHS病情和IL-6、CRP和TNF-α水平具有一定的相关性,对这3种炎性因子的检测有利于了解OSAHS的发生和发展机制.     

慢性乙型肝炎病毒携带者血清IL-1、IL-6和CRP水平与肝组织学相关研究

目的探讨慢性HBV携带者血清IL-1I、L-6和CRP水平与肝组织学变化的相关性。方法采用双抗体夹心ELISA法检测血清IL-1I、L-6;免疫比浊法检测血清CRP。采用在B超引导下快速肝穿刺活检术,肝组织炎症活动度分为轻度(G1-2/S0-2),中度(G3/S1-3),重度(G4/S2-4)。结果中、重度肝组织炎症活动者血清IL-1I、L-6和CRP水平显著高于轻度或无炎症改变者(P<0.05),轻度和无炎症改变者与正常对照组间比较无显著差异(P>0.05)。结论慢性HBV携带者血清IL-1I、L-6和CRP水平可以做为反应肝组织炎症活动程度的指标。     

The effects of different hemodialysis membrane on the levels of serum CRP, IL-6, IL-8 and albumin in hemodialysis patients

目的 探讨不同透析膜对维持性血液透析(MHD)患者血清C反应蛋白(CRP)、白细胞介素( IL)-6、白细胞介素-8和白蛋白(ALB)水平的影响.方法 选取维持性血液透析患者54例,随机分为纤维素膜组、聚砜膜F6组和聚砜膜F60组3组,每组18例.监测3组患者治疗前后C反应蛋白、白细胞介素-6、白细胞介素-8和白蛋白水平的变化,30例健康体检者作为对照组.结果 维持性血液透析患者透析前C-反应蛋白、白细胞介素-6及白细胞介素-8水平均高于对照组(P＜0.01),白蛋白水平低于对照组(P＜0.01).纤维素膜组单次透析后C反应蛋白、白细胞介素-6及白细胞介素-8水平上升(P＜0.01),聚砜膜F6组及聚砜膜F60组单次透析后C反应蛋白、白细胞介素-6及白细胞介素-8水平无明显变化(P＞0.05);聚砜膜F60组治疗8个月后C反应蛋白、白细胞介素-6及白细胞介素-8水平下降(P＜0.01),白蛋白水平上升(P＜0.05),纤维素膜组及聚砜膜F6组治疗8个月后C反应蛋白、白细胞介素-6、白细胞介素-8及白蛋白水平无明显变化(P＞0.05).结论 维持性血液透析患者存在微炎症状态,这种炎症状态与透析膜的生物相容性有关,高通量合成膜能改善维持性血液透析患者的微炎症状态.     

Frequency and pathogenesis of silent subcortical brain infarction in acute first-ever ischemic stroke

OBJECTIVES: We have often observed silent subcortical brain lesions on CT or MRI in first-ever ischemic stroke, but there is little published information on the relationship of these lesions to stroke subtypes. Here, we describe the incidence of MRI-detected silent subcortical brain lesions, including infarctions and white matter lesions, in a series of patients with first-ever ischemic stroke classified according to stroke subtypes. We also discuss the pathogenesis of these silent subcortical lesions. PATIENTS: We evaluated 171 patients with acute first-ever ischemic stroke. METHODS: The subjects were divided into three groups: lacunar, atherothrombotic and cardioembolic infarction groups. We evaluated silent subcortical brain infarction (SSBI), enlargement of perivascular space (EPS), and other white-matter lesions using MRI. RESULTS: Hypertension was observed in 67.6% of lacunar infarction, 57.1% of atherosclerotic infarction, and 54.1% of cardioembolic infarction. SSBI was more frequently observed in lacunar infarction than the others (lacunar vs. atherothrombotic vs. cardiogenic infarction, 81.5% vs. 44.4% vs. 42.1%, p=0.006). High-grade EPS (grade 2 or higher) was also observed more frequently in lacunar infarction than in the others (lacunar vs. atherothrombotic vs. cardiogenic infarction, 63.3% vs. 24.2% vs. 0%, p<0.001). Scheltens' score of silent subcortical lesions was significantly higher in lacunar infarction than in the others. CONCLUSIONS: The frequency of silent subcortical ischemic brain lesions was significantly higher in lacunar infarction than in atherosclerotic or cardioembolic infarction. We suggest that the pathogenesis of silent subcortical ischemic brain lesions is common to that of lacunar infarction, that is, small-vessel vasculopathy.     

Serum IL-6, TNFα and CRP levels in Greek colorectal cancer patients： Prognostic implications

AIM: The significance of preoperative serum IL-6, TNFα and CRP levels in the progression of colorectal cancer (CRC) has not been fully elucidated. Our intention was to investigate their role and identify their prognostic significance.METHODS: The IL-6, TNFα and CRP levels were measured in 74 CRC patients and the relationships between their elevations and both the clinicopathological factors and prognosis of patients were investigated. Serum concentrations of human IL-6 and TNFα were determined by enzyme-linked immunosorbent assay (ELISA). CRP was measured by an immunoturbinometric method. RESULTS: Median IL-6, TNFα and CRP levels were significantly higher in CRC patients than in normal controls. High levels of serum IL-6, TNFα and CRP were correlated with larger tumor size. Furthermore, high IL-6 and high CRP levels were associated with reduced overall survival. CONCLUSION: Serum IL-6, TNFα and CRP levels definitely increase in CRC patients. Pre-operative serum elevation of IL-6 and CRP was thus found to be predictor of the prognosis of CRC patients. The clinical value of TNFα in CRC needs to be further investigated.     

海南籍黎族和汉族急性脑梗死患者C反应蛋白和白细胞介素18的基因多态性研究

目的探讨C反应蛋白(CRP)-1059 G/C,白细胞介素18(IL-18)启动子基因-607 C/A和-137 G/C位点的基因多态性与海南黎、汉族人群急性脑梗死的相关性。方法选择汉族脑梗死患者115例为汉族脑梗死组和黎族脑梗死患者52例为黎族脑梗死组,分别与健康的汉族对照组116例和黎族对照组51例对照研究。测定CRP-1059 G/C、IL-18启动子基因-607 C/A和-137 G/C位点基因多态性。结果汉族脑梗死组CRP-1059 G/C位点C等位基因频率与汉族对照组比较,差异有统计学意义(P=0. 044),并且CRP-1059 G/C位点GG+GC基因型频率明显高于汉族对照组,CC基因型明显低于汉族对照组(78. 3%vs 87. 9%),差异有统计学意义(P=0. 049)。黎族脑梗死组CRP-1059 G/C、IL-18-607 C/A及IL-18-137 G/C位点的基因型和等位基因频率与黎族对照组比较,差异无统计学意义(P 0. 05)。多因素logistic回归分析显示,CRP-1059 GG+GC基因型为汉族脑梗死患者的独立危险因素(P 0. 05)。结论 CRP-1059 GG+GC基因型是海南籍汉族脑梗死患者的独立危险因素。而IL-18-607 C/A、IL-18-137 G/C基因多态性均与海南籍黎、汉族脑梗死患者无关。