进展性缺血性脑卒中患者血清IL-6和C-反应蛋白水平的变化及临床意义

目的探讨白细胞介素6(IL-6)、C-反应蛋白(CRP)在进展性缺血性脑卒中发病中的作用。方法分别采用双抗体夹心酶联免疫法和透射比浊法测定80例急性脑梗死患者不同时期血清IL-6、CRP水平变化,并根据临床神经功能缺损程度量表(NDS)评分判断是否发展为进展性脑卒中。另选40名健康体检者作为对照组。结果 80例急性脑梗死患者中有27例(33.75%)于7d内发展为进展性脑卒中,其发病后第1、3、7、14天外周血IL-6、CRP水平明显高于无进展的脑梗死患者(P0.05),第14天与正常对照组比较差异无统计学意义(P0.05)。发病当天IL-6、CRP水平与人院时体温、血白细胞数、血浆纤维蛋白原呈正相关(相关系数r=0.87、0.66、0.51,P均0.01),IL-6、CRP是进展性脑卒中危险因素。结论急性脑梗死患者血清IL-6、CRP增高与进展性缺血性脑卒中密切相关,可能在进展性缺血性脑卒中的发病过程中具有重要作用,监测血清IL-6、CRP水平对于监测疾病活动情况及严重程度等具有重要意义。

The changes of the serum IL-6 and C-reactive protein and their clinical significance in patients with progressive ischemic stroke

Objective To explore the role of the serum IL-6 and C-reactive protein(CRP)in pathogenesis of progressive ischemic stroke.Methods The levels of serum IL-6 and CRP in different stages in 80 patients with acute cerebral infarction were determined by double-antibody sandwich enzyme-linked immunosorbent assay and transmission turbidimetry,and the development of progressive stroke was determined on the basis of the clinical neurological deficits scale(NDS)score.The other 40 healthy volunteers were used as control group.Results Of 80 patients with acute cerebral infarction progressive stroke were found in 27 patients(33.75%)within 7 days of stroke.The levels of IL-6 and CRP in peripheral blood at 1st d,3rd d,7th d,14th d after stroke in patients with progressive stroke were significantly higher than that in patients without progressive stroke(P all<0.05).There was no significant difference in levels of IL-6 and CRP at 14th d between progressive stroke group and normal control group(P>0.05).IL-6.CRP were risk factors of progressive stroke.The levels of IL-6 and CRP on the first day were positively correlated with the body temperature,blood white cell count,plasma fibrinogen on admission(correlation coefficient r=0.87,0.66, 0.51,P all <0.01).Conclusion The increase of serum IL-6 and CRP were closely related to progressive ischemic stroke,and may play an important role in the pathogenesis of ischemic stroke.Monitoring the levels of serum IL-6 and CRP has a great significance for monitoring conditions of disease activity and severity.