脑梗死患者血同型半胱氨酸与炎症因子及神经功能缺损相关性研究

目的探讨脑梗死(CI)患者血同型半胱氨酸(Hcy)与炎症因子及神经功能缺损的相关性。方法收集2015年2月至2016年3月就诊的首次发病的CI患者90例,为CI组;选取同期于健康体检中心体检的健康人群90例,为对照组(C组)。检测血清中Hcy、高敏C反应蛋自(hs-CRP)、肿瘤坏死因子(TNF-α)、白细胞介素(IL)-1β、IL-6及IL-10;记录患者临床神经功能缺损评分(CNDS)评分;分析Hcy与炎症因子、CNDS的相关性。结果与C组比较,CI组患者血清中Hcy(23.57±8.64)μmol/L比(9.89±4.58)μmol/L]、hs-CRP(4.32±1.41)mg/L比(0.69±0.31)mg/L]、TNF-α(31.24±6.34)pg/ml比(6.15±2.59)pg/ml]、IL-1β(1.31±0.25)pg/ml比(0.34±0.11)pg/ml]、IL-6(15.62±3.59)pg/ml比(2.19±1.42)pg/ml]均显著升高,IL-10(5.19±2.13)pg/ml比(15.12±3.42)pg/ml]显著降低,差异均有统计学意义(P<0.01)。根据CNDS评分标准,将CI组患者分为3个亚组,其中,CI轻度组23例,CI中度组36例,CI重度组31例;与C组比较,CI组3个亚组患者CNDS评分均显著升高(P<0.05)。相关性分析显示,Hcy与hs-CRP、TNF-α、IL-1β、IL-6呈正相关(Rs>0,P<0.05),与IL-10呈负相关(Rs<0,P<0.05)。血清中Hcy与CI轻度、中度患者的CNDS评分呈正相关(r=0.691、r=0.632,P<0.05),而重度患者CNDS评分与血清中Hcy无相关性(r=0.049,P>0.05)。结论 CI患者血清中Hcy与炎症因子及神经功能缺损具有相关性,可反应CI患者的炎症状态和病情的严重程度。

Correlation in serum homocysteine,inflammatory factor and nerve function damage degree in patients with cerebral infarction

Objective To investigate the correlation in serum homocysteine( Hcy) ,inflammatory factor and nerve function damage de-gree in patients with cerebral infarction( CI) . Methods Clinical samples was collected from 90 CI patients with first episode( Group CI) who were received in the Liaoning Provincial People′s Hospital from February 2015 to March 2016,while the others were collected from 90 healthy volunteers as the control group( Group C) from the hospital health examination center in the same period. The serum Hcy,high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukine(IL)-1β,IL-6 and IL-10 were in-spected;the clinical neural function defect scale(CNDS) of patients was recorded;correlation in Hcy,inflammatory factor and CNDS was analyzed. Results Compared with Group C,in CI patients,Hcy(23. 57 ± 8. 64) μmol/L versus (9. 89 ± 4. 58) μmol/L],hs-CRP(4. 32 ± 1. 41) mg/L versus (0. 69 ± 0. 31) mg/L],TNF-α(31. 24 ± 6. 34) pg/ml versus (6. 15 ± 2. 59) pg/ml],IL-1β(1. 31 ± 0. 25) pg/ml versus (0. 34 ± 0. 11) pg/ml] and IL-6(15. 62 ± 3. 59) pg/ml versus (2. 19 ± 1. 42) pg/ml] were signifi-cantly increased,IL-10(5. 19 ± 2. 13) pg/ml versus (15. 12 ± 3. 42) pg/ml] was significantly decreased,and all the differences had statistical significance(P<0. 01). According to CNDS standard,the Group CI was divided into three subgroups,including 23 cases of mild CI,36 cases of moderate CI and 31 cases of severe CI;compared with group C,CNDS scores of all CI patients were significantly increased(P<0. 05). Correlation analysis showed that,Hcy was positively correlated to hs-CRP,TNF-α,IL-1β and IL-6(Rs>0,P<0. 05),and was negatively correlated to IL-10(Rs<0,P<0. 05). Serum Hcy was positively correlated to mild CI and moderate CI CNDS score(r = 0.691,r = 0.632,P < 0.05),and was not correlated to severe CI CNDS score(r = 0.049,P > 0.05). Conclusion There is correlation in the serum Hcy,inflammatory factor and nerve function damage in CI patients,which is reactive in-flammation and severity of the condition of CI patients.