急性脑梗死后炎症因子的动态变化及其与神经功能的相关性研究

目的 探讨脑梗死后炎症因子水平的变化以及与神经功能评分的关系.方法收集2012年5月-2013年10月治疗的35例脑梗死患者（入院时、发病后3 d、7 d、14 d）和43例健康体检者血液,分析炎症因子水平与神经功能评分（NIHSS评分、Barthel指数）的相关性.结果 观察组患者血清中白介素（IL）-1β、IL-6、肿瘤坏死因子（TNF）-α和γ-干扰素（IFN-γ）在入院时、发病后3 d、7 d、14 d各时点浓度均高于对照组（P＜0.05,P＜0.01）;各炎症因子水平发病24 h内升高,并在卒中后14 d内达到最高水平.入院时血清IL-6水平与入院时NIHSS评分呈正相关,与Barthel指数无相关性;入院时血清IL-1β、IL-6水平与发病14 d的NIHSS评分呈正相关,与Barthel指数呈负相关.结论脑梗死后血清IL-1β、IL-6、TNF-α和IFN-γ等炎症因子均增高,并与入院时和卒中14 d时的神经功能评分相关,血清炎症因子水平可在一定程度上反映早期卒中严重度及预后.

Relationship between Dynamic Changes of Inflammatory Cytokines with Neurological Function after Acute Cerebral Infarction

Objective To investigate the relationship between dynamic changes of inflammatory cytokines with neurological function after acute cerebral infarction. Methods A total of 35 patients with acute cerebral infarction and 43 physical examinees between May 2012 and October 2013 were enrolled in the study. The blood samples were collected upon admission, 3 d, 7 d and 14 d after stroke onset in 35 patients and 43 examinees. The relationships between levels of inflammatory cytokines （National Institutes of Health Stroke Scale, NIHSS scores） with neurological function （Barthel indexes） were analyzed. Results The levels of serous interleukin-1 3 （ IL-1 3） , IL-6, tumor necrosis factor-ct （TNF-ct） and interferon-~/ （IFN-＇,/） in stroke group upon admission, 3 d, 7 d and 14 d after stroke onset were higher than those in control group; levels of inflammatory cytokines were higher within 24 hours after onset, and the highest level was found within 14 d after onset. The IL-6 level was positively correlated with NIHSS scores upon admission, but the level was not correlated with Barthel indexes; The levels of IL-113 and IL-6 upon admission were positively correlated with NIHSS scores 14 d after stroke onset, and the levels were negatively correlated with Barthel indexes. Conclusion The levels of serous IL-1β, IL-6, TNF-α and IFN-γ are increased after cerebral infarction, and the levels are correlated with Barthel indexes upon admission and 14 d after onset. The levels of inflammatory cytokines may reflect severity and prognosis of early stroke in a certain degree.