进展性脑梗死患者血清HMGB1、FKN动态变化研究

目的探讨高迁移率族蛋白B1(HMGB1)及不规则趋化因子(FKN)在进展性脑梗死中的可能作用机制。方法用酶联免疫吸附试验(ELISA)法检测急性脑梗死患者不同时期血清HMGB1及FKN水平变化,根据斯堪的纳维亚脑卒中量表(scandinavian stroke scale,SSS)评分分为进展组和非进展组。根据梗死体积将180例患者分为大梗死灶组、中梗死灶组、小梗死灶组。另纳入30例健康体检者作为对照组。结果 180例急性脑梗死患者中有35例(19.44%)发展为进展性脑梗死。进展组SSS基线评分低于非进展组,差异有统计学意义(P0.05)。进展性组患者发病后1 d、7 d、14 d血清HMGB1、FKN水平高于非进展组和对照组,有统计学意义(P0.05)。梗死灶体积大则血清HMGB1、FKN水平高(P0.05)。结论血清HMGB1、FKN增加可能通过增加炎症反应促进动脉粥样硬化形成和进展,加重脑组织损伤,导致脑梗死患者病情进展。

Changes and clinical significance of serum HMGB1,FKN inpatients with progressive ischemic stroke

Objective To investigate the role of high mobility group box (HMGB) 1 and fractalkine/CX3CL1 (FKN) in progressive ischemic stroke.Methods The serum levels of HMGB1 and FKN in patients with acute cerebral in-farction at different perids were detected by ELISA .According to Scandinavian Stroke Scale ( SSS) ,patients divided into pro-gressive group and non-progressive group .According to the infarct volume , 180 cases were divided into large infarction group,middle infarction group and small infarction group .30 asymptomatic healthy individuals who underwent annual health check up were chosen as control .Results Among 180 patients,35 patients (19.44%) were progressive stroke.The SSS basic score of progressive group was lower than non-progressive group (P<0.05).The levels of HMGB1,FKN in progres-sive group were higher than non-progressive group and control group at the 1st,7th,14th day after stroke onset(P<0.05). The levels of HMGB1,FKN was higher in patients with bigger size infarction (P<0.05).Conclusion The increase of the levels of HMGB1,FKN may promote and formate of atherosclerosis through increaseing the inflammatory response ,which may deteriorate brain injury and lead to early neurological evolution .