急性脑梗死患者致炎细胞因子和早期神经功能恶化的关系

Investigation on relationship between proinflammatory cytokines and early neurological worsening in patients of acute cerebral infarction

目的 :探讨白介素 6 (IL 6 )和肿瘤坏死因子 α(TNF α)在急性脑梗死早期神经功能恶化中的意义。方法 :选 2 12例初发急性脑梗死患者为研究对象 ,分为神经功能恶化组 80例 ,非恶化组 132例。用酶联免疫吸附法测定并比较IL 6和TNF α水平。结果 :80例患者于发病后 4 8h内神经功能恶化。血浆和脑脊液中IL 6是神经功能恶化的独立危险因素。血浆IL 6与体温、血糖、纤维蛋白原和梗死体积相关。神经功能恶化组血浆和脑脊液中TNF α明显高于非恶化组。结论 :IL 6参与脑缺血后急性期反应 ,与早期神经功能恶化相关。

Objective:To assess the implication of interleukin -6(IL-6) and tumor necrosis factor -α(TNF-α) in early neurological worsening in ischemic stroke. Methods: Two hundred and twelve patients admitted with first-ever ischemic cerebral infarction within the first 24 hours from onset were included. IL-6 and TNF-α in plasma and cerebrospinal fluid(CSF) were determined with enzyme-linked immunoadsorbent assay.Results:Eighty patients deteriorated within the first 48 hours. IL-6 in plasma and CSF were independent factor for early clinical worsening with multiple logistic regression. IL-6 in plasma was highly correlated with body temperature, glucose, fibrinogen, and infarct volume. CSF and plasma concentrations of TNF-α were higher in patients who deteriorated, but the differences observed did not remain significant on multivariate analysis.Conclusion:In addition to participating in the acute-phase response that follows focal cerebral ischemia, IL-6 levels on admission are associated with early clinical deterioration.