脑梗死患者血清IL-6水平变化观察

Changes of serum IL-6 in cerebral infarcts

目的分析急性脑梗死患者血清IL-6水平变化及其和脑梗死体积的关系.方法收集2002年7月～2003年1月在湘雅医院神经内科就诊的发病3 d以内的符合试验入选标准的脑梗死患者32例及相匹配的同期体检者30例,放免法测定血清IL-6浓度.同时对11例发病24 h内入院的患者进行血清IL-6水平的动态观察(发病第2天、第3天和第6天).所有脑梗死患者依据发病后48～72 h的CT检查结果计算脑梗死体积.结果发病3天内(测定时间距发病时间平均为(47.4±5.6)h脑梗死患者和正常对照组血清IL-6水平分别为(352.1±31.7)pg/ml和(135.4±18.3)pg/ml,二者差异显著,P＜0.001;脑梗死患者发病后第1天、第3天和第6天血清IL-6水平分别为(364±29.7)pg/ml、(345±28.9)pg/ml和(308±26.8)pg/ml,其中发病第1天和第3天比较差异无显著性,P＞0.05;发病第6天较第3天明显降低,P＜0.01,但仍高于正常对照组,P＜0.001;发病3 d内血清IL-6水平和脑梗死体积呈正相关,相关系数为0.368,P＜0.05.结论急性脑梗死患者血清IL-6水平升高,并存在动态变化,其高峰值可能在发病后3 d内,其值和脑梗死体积呈正相关.

Objective: To explore the changes and the correlation with the infarct volume of IL-6 in patients with acute cerebral infarcts. Methods: 32 patients at Xiangya Hospital experienced infarcts that occurred within the first 3 days were consecutively incorporated into the study between July 2002 and January 2003, and 30 healthy subjects were selected as control group. The serum level of IL-6 was measured by RIA. 11 patients that experienced stroke within 24 hours were observed at first day, third day and sixth day. The subsequent volume of brain lesion as a consequence of stroke was measured by CT within 48~72 hours after the onset. Results: The serum level of IL-6 was significantly lower in patients within the first three days after onset than that of control subjects (135.4±18.3pg/ml vs. 352.1±31.7pg/ml, P<0.001). ②The level of IL-6 in the sixth day was (308±26.8) pg/ml and it was lower with significance than that in the first day (364±29.7pg/ml) and in the third day (345±28.9 pg/ml). There is no significant difference between the first day and the third day (P>0.05). The level of IL-6 is still higher in patients within the sixth day after onset than that of control subjects (P<0.001). ③It displays the positive correlation between the level of IL-6 in the first three days after onset and the infarct volume. And the correlation coefficient is 0.368 (P<0.05). Conclusions: The serum level of IL-6 is upregulated and displays a motive changes. The peak level may be within the first three days. The infarct volume is in positive correlation with the level of IL-6.