物理因子治疗对脑梗死患者血清hs-CRP、TNF-α和脂联素的影响及其意义

Effects and implications of physical modalities on hs-CRP,TNF-α and adiponectin in patients with cerebral infarction

目的 观察物理因子治疗对脑梗死患者血清高敏C反应蛋白（hs—CRP）、肿瘤坏死因子α（TNF-α）和脂联素水平的影响，并探讨其可能机制。方法60例脑梗死患者随机分为物理因子治疗组（综合组）30例和单纯药物治疗组（药物组）30例，并于治疗前、后用乳胶凝集反应法测定血清hs-CRP水平、ELISA法测定血清TNF-α和脂联素含量。并选取30例健康体检者作为正常对照组（对照组）。结果脑梗死患者治疗前，血清hs—CRP和TNF—α水平明显较对照组高（P〈0．01），脂联素水平明显较对照组低（P〈0．01）。综合组和药物组经治疗后，血清hs-CRP和TNF—α含量均较治疗前降低（P〈0．01），脂联素水平较治疗前显著提高（P〈0．01）；综合组hs-CRP和TNF-α水平的下降较药物组更明显（P〈0．05），脂联素水平提高也更显著（P〈0．05）。结论物理因子治疗脑梗死的机制可能与其降低患者血清hs-CRP、TNF-α含量及提高脂联素水平，促进内皮功能修复等因素有关。

Objective To observe the effects of physical agents therapy on serum hs-CRP, TNF-α and adiponectin in patients with cerebral infarction and the possible underlying mechanisms. Methods Sixty patients with cerebral infarction were randomly and equally divided into two groups： 30 cases were treated with physical agents therapy （ physical therapy group） , and 30 with drugs only （ drug treated group）. Thirty normal subjects served as the control group. The level of hs-CRP in the serum was determined by latex agglutination reaction, TNF- α and adiponectin were determined by using ELISA before and after therapy. Results The levels of serum hs- CRP and TNF-α of patients with cerebral infarction before therapy were much higher than those of the control group, but adiponectin was significantly lower than those of the control group（ P 〈 0.01 ）. After therapy, the levels of ser- um hs-CRP and TNF-α were decreased and adiponeetin was increased significantly in both treated groups （P 〈 0.01 ）. Comparison with two treated groups showed that the levels of hs-CRP and TNF-α were lower and adiponectin was obviously higher in physical agents therapy group than those in the drug treated group （ P 〈 0.05 ）. Conclusion The patients with cerebral infarction have low level of serum adiponectin. Physical therapy might exert beneficial effects on patients with cerebral infarction by the decreasing serum hs-CRP and TNF-α, as well as by elevating adiponectin.