缺血性卒中后血浆超敏C-反应蛋白和白介素-6的早期动态变化与临床表现的关系探讨

目的 观察急性缺血性卒中患者发病后早期血浆超敏C反应蛋白（high sensitive C-reactive protein，hs-CRP）及白介素-6（interleukin-6，IL-6）水平的动态变化规律，探讨其与卒中患者临床表现及预后的关系。方法 连续入选急性缺血性卒中患者47例，正常对照组40例，比较卒中组发病后系列时间点血浆hs-CRP和IL-6水平与正常对照组之间的差异，分析其动态变化规律；按照基线美国国立卫生研究院卒中量表（national institutes of health stroke scale，NIHSS）评分将患者分为轻型组（n=15）和重型组（n=32），比较两组血浆hs-CRP和IL-6水平；并比较不同临床预后患者血浆hs-CRP和IL-6水平的差异。结果 卒中组发病3h时血浆hs-CRP较对照组差异无统计学意义，6 h、12 h、24 h、48 h、3 d及7 d血浆hs-CRP较对照组明显升高（均P ≤0.01）。卒中组各时间点血浆IL-6水平均高于正常对照组（均P <0.01）。重型组血浆hs-CRP水平在12 h、24 h、48 h、3 d及7 d时水平均高于轻型组（P =0.046，0.012，0.030，0.007，0.041）；重型组血浆I L-6水平在12 h、24 h、48 h、3 d及7 d时水平均高于轻型组（P =0.002，0.001，0.006，0.026，0.043）。不同预后组之间血浆hs-CRP和IL-6水平差异不明显。结论 急性缺血性卒中患者血浆hs-CRP和IL-6水平升高，且与临床严重程度有关。

Early Time Course of Serum High Sensitive C-reactive Protein and interleukin-6 after Acute Ischemic Stroke

Objective To investigate the early time course of plasma high sensitive C-reactive protein （hs- CRP） and interleukin-6 （IL-6） level after acute ischemic stroke and the relationship with clinical characters and outcome. Methods Serial enrollment of acute ischemic stroke patients （n=47） and healthy controls （n=40）. We compared the serial measurements of plasma hs-CRP and IL-6 level of acute ischemic stroke patients with that of healthy controls, and analyzed their dynamic variation rules. Patients were divided into mild stroke （n-15） and severe stroke （n=32） group according to national institutes of health stroke scale （NIFISS）. We compared the plasma level of hs-CRP and IL-6 of the two groups, and also that of the patients with good and poor outcome. Results There was no difference of plasma hs-CRP at 3h between stroke patients and healthy controls, but was significantly higher in stroke patients at 6h （P=0.01）, 12h （P=0.01）, 24h （P〈0.01）, 48h （P〈0.01）, 3d （P〈0,01） and 7d （P〈0.01） than controls. Plasma IL-6 of stroke patients at each time points was significantly higher than that of the controls （P〈0.01）. Hs-CRP level of severe stroke patients was significantly higher than mild ones at 12h, 24h, 48h, 3d and 7d （p=-0.046, 0.012, 0.030, 0.007 and 0.041, respectively）. The same was also true for IL-6 at those time points （P=0.002, 0.001, 0.006, 0.026 and 0.043, respectively）. There was no difference of plasma hs-CRP and IL-6 level between patients with good and poor outcome.Conclusion Plasma hs-CRP and IL-6 levels elevated after acute ischemic stroke, and correlated with clinical severity.