脑梗死患者血清IL-6和sICAM-1变化及临床意义

Changes and clinical significance of serum IL-6, sICAM-1 in patients with cerebral infarcts

目的 :分析急性脑梗死患者血清IL 6 ,sICAM 1变化及临床意义 ,探讨其在脑缺血炎性病理损伤中的可能作用机制。方法 :选择发病 3d以内的符合试验入选标准的脑梗死患者 32例 ,同时收集相匹配的同期体检者 30例 ,分别用放射免疫法和酶联免疫吸附法测定血清IL 6和sICAM 1浓度。其中 11例发病 2 4h内入院的患者进行血清IL 6和sICAM 1水平动态观察 (发病第 1d ,第 3d和第 6d)。所有脑梗死患者依据发病后 4 8～ 72h的CT检查结果计算脑梗死体积。结果 :发病 3d内 [测定时间距发病时间平均为 (4 7.4± 5 .6 )h]脑梗死患者血清IL 6浓度和sICAM 1浓度均显著高于正常对照组 [(35 2 .1± 31.7)pg/mlvs.(135 .4± 18.3)pg/ml和 (36 3.6± 4 8.4 )ng/mlvs.(2 2 7.2± 30 .1)ng/ml,P <0 .0 1]。IL 6和sICAM 1浓度随发病后时间的推移而逐渐下降 ;IL 6浓度在发病第 1d[(36 4 .5± 2 9.7)pg/ml]与第 3d[[(345 .7± 2 8.9)pg/ml]比较无统计学意义 (P >0 .0 5 ) ,发病第 6d[(30 8.3± 2 6 .8)pg/ml]较第 3d明显降低 (P <0 .0 1) ;sICAM 1浓度在发病第 1d[(383.9± 5 6 .1)ng/ml],第 3d[(35 4 .6± 4 0 .8)ng/ml]和第 6d [(316 .7± 32 .3)ng/ml]三个时间点两两比较差异显著 (P <0 .0 5 ) ;IL 6和sICAM 1浓度至第

Objective To analyze the changes and clinical significance of IL-6 and sICAM-1, and to explore their pathologic mechanism in the brain ischemia.Methods Thirty-two patients at Xiangya Hospital who experienced infarcts that occurred within the first 3 days were consecutively selected into the study, and 30 healthy subjects were selected as controls.The serum level of IL-6 and sICAM-1 was measured by radioimmunoassy and enzyme linked immunosorbent assay. Eleven out of the 32 patients that experienced stroke within 24 hours were observed on the 1st , 3rd , and 6th day. The subsequent volume of brain lesion as a consequence of stroke was measured by CT within 48～72 hours after the onset.Results Both the serum levels of IL-6 and sICAM-1 were significantly higher in patients within the first 3 days after the onset than those of the controls [(352.1±31.7) pg/ml vs. (135.4±18.3) pg/ml, and ( 363.6 ±48.4) ng/ml vs. (227.2±30.1) ng/ml, P<0.01]. The levels of IL-6 at the 6th day [( 308.3 ± 26.8 ) pg/ml] was significantly lower than that both on the 1st day [(364.5±29.7) pg/ml] and on the 3rd day [(345±28.9) pg/ml](P<0.01). There was no significant difference between the 1st day and the 3rd day (P>0.05). Statistical significance existed in each two concentrations of sICAM-1 on the 1st day[(383.9±56.1) ng/ml], the 3rd day [(354.6±40.8) ng/ml], and the 6th day [(316.7±32.3) ng/ml](P<0.05). Both the levels of IL-6 and sICAM-1 were higher in patients within the 6th day after the onset than those of sICAM-1 on the controls (P<0.01). There was a positive correlation between both the levels of IL-6 and sICAM-1 at the first 3 days after the onset and the infarct volume (r=0.368, P<0.05 and r=0.594, P<0.01), and the sICAM-1 positively correlated with IL-6 (r=0.453,P< 0.05 ). Conclusion The serum levels of IL-6 and sICAM-1 were upregulated, which might play a role in inflammatory lesion, and the upregulation of sICAM-1 may be related to the IL-6. The levels of IL-6 and sICAM-1 may reflect both the degree of pathologic lesion after the brain ischemia and the infarct volume.