急性脑梗死患者血清补体水平及其动态变化

Serum level of terminal complement complex and its dynamic alteration in patients with acute ischemic stroke

目的:研究急性脑梗死患者血清中补体末端复合体(TCC)含量与脑梗死体积及预后的关系。方法:98例急性脑梗死患者(病例组)及95例健康对照者(对照组)来自山东大学附属省立医院,病例组患者均于出现症状24h内入组。在确诊当时及第1、2、3、4、6、10天各留取血液标本1次,测定血清TCC水平。梗死体积为第7天CT经Simes Somatom所提供的软件测得。神经功能恢复评定标准为修正的Rankin等级评分。结果:(1)病例组卒中发作初期血浆TCC含量与对照组差异无显著性,48hTCC含量明显增加,到第6天达到最高,第10天仍高。(2)血清TCC含量与脑梗死体积及Rankin等级评分有相关性。结论:(1)急性脑梗死后补体激活参与了卒中后炎症反应。(2)TCC含量与梗死体积及患者预后密切相关,能反映卒中时脑组织的损害程度,可以作为脑梗死患者简单易行、价廉有效的预测指标。

Objective To investigate the association of serum terminal complement complex （TCC） levels with the infarct volume and prognosis in patients with acute ischemic stroke. Methods 98 patients with acute ischemic stroke who visited our hospital within 24 hours of symptom onset and 95 healthy subjects were recruited in this study. Serum level of TCC was determined at the time of diagnosis and at days 1 to 4, 6 and 10. The infarct volume was detected by CT on day 7 and the neural function was assessed by using the modified Rankin scale 3 months after the onset of stroke. Results TCC did not differed significantly between the patients and the control subjects in the early stage of the onset, but it increased markedly at day 2, peaked at day 6, and maintained in a high level at day 10. TCC level was associated with the infarct volume and the modified Rankin scale score. Conclusions TCC activation is involved in the inflammatory reaction after acute ischemic stroke. TCC level is closely related with the infarct volume and prognosis. It can reflect the degree of cerebral injury and be used as an effective predictor for stroke.