缺血性脑血管病患者TNF-α、IL-6和IGF-Ⅱ水平变化及临床价值的探讨

Clinical Significance of Changes of Serum TNF-α,IL-6 and IGF-Ⅱ Levels in Patients with Ischemic Cerebral Vascular Disease

目的:探讨缺血性脑血管病(ICVD)患者血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和胰岛素样生长因子-Ⅱ(IGF-Ⅱ)水平变化及临床价值。方法:采用放射免疫分析对131例ICVD患者进行血清TNF-α、IL-6和IGF-Ⅱ检测,同时与35例正常人比较。结果:急性脑梗死(ACI)患者血清TNF-α、IL-6和IGF-Ⅱ水平均较正常对照组增高显著(P<0.01),脑梗死后遗症(SCI)患者血清TNF-α、IL-6和IGF-Ⅱ水平低于急性脑梗死组但明显高于正常对照组(P<0.05),椎基底动脉供血不足(VBI)和脑动脉硬化(CA)患者TNF-α和IGF-Ⅱ水平较正常对照组亦有明显增高(P<0.05)。结论:细胞因子TNF-α、IL-6和IGF-Ⅱ在ICVD病理过程中发挥重要的作用,其水平变化对疾病预后、发展及了解病情、指导治疗具有重要临床价值。

Objective To investigate the clinical significance of changes of serum expression of TNF-α, IL - 6 and IGF - Ⅱ in patients with ischemic cerebral vascular disease. Methods Serum expression of TNF-α, IL - 6 and IGF-Ⅱ were determined with RIA in 131 patients with different types of ICVD （（1）acute cerebral infarction n = 21 （2） sequale of cerebral in farction n = 42 （3） verte-brobasilar ischemia n = 32 （4） cerebral arteriosclerosis n = 36） and 35 controls. Results The serum levels of TNF-α, IL - 6 and IGF - Ⅱ in patients with ACI were significantly higher than those in controls （P 〈 0.01 ）. Serum levels in patients with SCI were lower than those in patients with ACI, but higher than those in controls （P 〈 0.05）. The serum levels of TNF-α and IGF-Ⅱ in patients with VBI and CA were also significantly higher than those in controls （P 〈 0.05）. Conclusion TNF-α, IL - 6 and IGF-Ⅱ may play important roles in the pathogenesis of ICVD, and detection their serum expression can be of help in the assessment of disease progress and prognosis.