进展性缺血性脑卒中患者血IL-6、TNF-α、S-100b蛋白水平的变化及临床意义

Changes and clinical significance of serum IL-6,TNF-α,S-100b protein in patients with progressive ischemic stroke

目的探讨白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、S-100b蛋白在进展性缺血性脑卒中发病中的作用。方法用双抗体夹心酶联免疫法测定50例急性脑梗死患者不同时期血清IL-6、TNF-α、S-100b蛋白水平变化,并根据神经功能缺损(SSS)评分判断是否发展为进展性脑卒中。另纳入30例健康体检者作为对照组。结果50例急性脑梗死患者中有19例(38.0%)于7d内发展为进展性脑卒中,其发病后第1d、3d、7d、14d外周血IL-6、TNF-α、S-100b蛋白水平明显高于无进展的脑梗死患者,第14d与正常对照组无明显差异(P>0.05)。发病当天IL-6、TNF-α水平与入院时体温、纤维蛋白原呈正相关(r=0.52、0.61,P均<0.01),S-100b蛋白峰浓度与IL-6、TNF-α峰浓度呈正相关(r=0.52、0.61,P均<0.01)。结论急性脑梗死患者血清IL-6、TNF-α、S-100b蛋白增高与进展性缺血性脑卒中密切相关,可能在进展性缺血性脑卒中的发病过程具有重要作用。

Objective To investigate the role of interleukin-6（IL-6）, tumor necrosis factor-α（TNF-α）, and S- 100b protein in pathogenesis of progressive ischemic stroke. Methods The serum levels of IL-6, TNF-α and S-100b protein in 50 patients with acute cerebral infarction at different periods were detected by ELISA. The progressive ischemic stroke was defined according to neurological function defect scale score（SSS）. Results Among 50 paitents, 19 patients（38.0% ） were progressive stroke within 7 days. The levels of IL-6, TNF-α, S-100b protein in patients with progressive stroke were significantly higher than those in patients with non-progressive stroke at the 1st, 3rd, 7th, 14th day after stoke onset, but there was no significant difference at the 14th day, as compared with those of control group（ P 〉 0.05）.The levels of IL-6,TNF-α at the first day of onset were positively correlated with patients＇ body temperature and fibrinogen（ r = 0.52,0.61, P 〈 0.01 ）, and the levels of S-100b protein were positively correlated with the levels of IL-6, TNF-α（ r = 0.52,0.61, P 〈 0.01 ）. Conclusion The increase of the levels of IL-6, TNF-α, 100b protein is desely related with progressive ischemic stroke, which may play an important role in the pathogenesis of progressive ischemic stroke.