缺血性脑血管病介入治疗对炎性细胞因子影响的研究

目的观察缺血性脑血管病患者相关血管开通前后致炎细胞因子肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和抗炎细胞因子白细胞介素-10（IL—10）的动态变化。方法采用酶联免疫吸附法测定30例健康人（健康对照组）和30例缺血性脑血管病患者急诊介入治疗术前即刻、术后12、24h，血浆TNF-α、IL-6；IL-10的变化，比较致炎细胞因子TNF-α、IL-6和抗炎细胞因子IL-10的动态变化。结果再灌注前急诊介入组患者TNF-0L、IL-6显著高于健康对照组（P〈0．05），血浆IL-10略高于健康对照组，但差异无统计学意义（P〉0．05）；再灌注后12、24h急诊介入组患者血浆TNF--α、IL-6、IL-10均较术前显著增高（P〈0．01，P〈0．05）。急诊介入组患者再灌注治疗后12h抗炎细胞因子IL-10的升高幅度显著低于致炎细胞因子TNF-α、IL-6的升幅（P〈0．01）。结论缺血性脑血管病再灌注后致炎细胞因子较抗炎细胞因子增高更显著。

The influence of emergency percutaneous intervention on plasma cytokines in patients with ischemic cerebrovascular disease

Objective To observe the dynamic changes of tumor necrosis factor-alpha interleukin-6 and interleukin-10 in patients with ischemic cerebrovascular disease（ICVD） before and after recanalization of infarctrelated artery. Methods In 30 IVCD patients and 30 normal people as a control group,plasma TNF-α, IL-6 and IL-10 were measured by ELISA before emergency percutaneous intervention, 12 h and 24 h post-intervention. Amplitudes of changes in plasma TNF-α, IL-6 and IL-10 were compared. Results Plasma IL-10 in ICVD was not significantly higher than that in control group （ P 〉 0. 05 ） before emergency pereutaneous intervention, but TNF-α and IL-6 significantly higher（ P 〈 0. 05 ）. Plasma TNF-α, IL-6 and IL-10 at 12 h and 24 h post-intervention were significantly higher than those before percutaneous intervention （P 〈 0. 01, P 〈 0. 01, P 〈 0. 05 ）, but the amplitude of IL-10 increase was significantly less than that of TNF-α, IL-6 （ P 〈 0. 01 ）. Conclusion TNF- α, IL-6 and IL-10 may be involved in ischemia-reperfusion injury. The imbalance between inflammation-promoting and anti-inflammatory eytokines may be one of the mechanisms resulting in isehemia-reperfusion injury.