急性脑梗死患者血清IL-6、TNF-α、S-100b变化及临床意义

Changes and Clinical Significance of Serum IL-6,TNF-α,and S-100b in Patients with Acute Cerebral Infarction

目的分析急性脑梗死患者血清IL-6、TNF-α、S-100b的动态变化规律及临床意义。方法选择发病24 h以内的符合试验入选条件的颈内动脉系统急性脑梗死患者58例,同时收集相匹配的同期体检者30例作为对照组,用ELISA法测定血清IL- 6、TNF-α、S-100b浓度。病例组进行动态监测,并同时记录患者神经功能缺损评分(NIHSS)。所有急性脑梗死患者依据发病后72h的脑CT扫描结果计算脑梗死体积。结果急性脑梗死患者血清IL-6、TNF-α、S-100b发病当天就明显增高,IL-6、TNF-α发病后第1d即达高峰,S-100蛋白第3d达高峰。其后浓度随时间的推移逐渐下降。血清IL-6、TNF-α、S-100b的峰值浓度和脑梗死体积、NIHSS评分呈正相关。发病后进展性脑卒中患者血清IL-6、TNF-α和S-100b蛋白高峰水平高于无进展性脑卒中患者。结论急性脑梗死患者血清IL-6、TNF-α和S-100b蛋白水平升高,与进展性脑卒中相关。血清水平值能够反映脑缺血后病理损伤的程度和脑梗死体积大小,可能作为急性脑梗死病人病情的标志物。

Objective To analyse the dynamic changes and clinical significance of IL-6,TNF-α,and S-100b in patients with acute cerebral infarction.Methods Fifty eight patients with acute ischemie cerebral infarction of internal carotid artery system whose onsets were within first 24 hours and in accordance with the experimental conditions were selected;thirty healthy subjects were selected as controls.The concentration of the serum IL-6,TNF-α,and S-100b was measured by enzyme linked immunosorbent assay,also their dynamic changes in all patients were observed on the 1st,3rd,7th and 14th day.The severity of stroke was scored at the same time by the National Institues of Health Stroke Seale(NIHSS).The volume of the infarction was measured by CT at 72h after the onset.Results The serum levels of IL-6,TNF-α,and S-100b in patients were significantly higher on the same day than those of the controls.The levels of IL-6,TNF-αreached the peak within 24 hours after stroke and the S-100 rose to peak on the 3rd day.Their levels gradually reduced as time went on.There was a positive correlation between the peak value of IL-6,TNF-α,and S-100b and the infarct volume and NIHSS.The serum levels of IL-6,TNF-α,and S-100b in patients with progressive stroke were higher than those in patients with non-progressive stroke.Conclusion The increased serum levels of IL-6,TNF-α,and S-100b in patients with acute cerebral infarction are connected with the progressive stroke.The levels of IL-6,TNF-α,and S-100b may reflect both the degree of pathologic lesion and the infarct volume.They might be regarded as biomarkers of acute ischemic stroke.