急性脑梗死与血清白细胞介素-17关系的临床研究

Clinical study on the relationship between acute cerebral infarction and serum interleukin- 17

目的 检测急性脑梗死患者血清白细胞介素-17（IL-17）水平,探讨IL-17在脑梗死发病中的作用.方法 采用酶联免疫吸附试验（ELISA）检测急性脑梗死患者血清IL-17水平,并与正常对照组比较.根据脑梗死体积大小分为3组：小梗死组（≤4.0 cm3）,中梗死组（4.1～10.0 cm3）,大梗死组（＞10.0 cm3）.根据美国国立卫生研究所卒中量表（NIHSS）评分分为3组：轻型组（＜4分）,中型组（4～15分）,重型组（＞15分）.根据颈动脉粥样硬化斑块所致狭窄的程度分为3组：轻度狭窄组（＜50%）,中度狭窄组（50%～70%）,重度狭窄组（＞70%）.观察患者血清IL-17水平的变化与脑梗死体积、临床神经功能缺损程度评分、颈动脉粥样硬化斑块的关系.结果 不同梗死体积组的患者血清IL-17水平明显高于正常对照组（P〈0.01）,且各组之间存在显著性差异（P〈0.05）,IL-17水平随梗死灶体积的增加而升高;不同神经功能缺损评分组患者血清IL-17水平明显高于正常对照组（P〈0.01）,且各组之间存在显著性差异（P〈0.05或〈0.01）,IL-17水平随神经功能缺损评分的增加而升高;不同程度颈动脉粥样硬化狭窄组血清IL-17水平明显高于正常对照组（P〈0.01）,且各组之间存在显著性差异（ P〈0.05）,IL-17水平随颈动脉狭窄程度的增加而升高.结论 急性脑梗死患者血清IL-17水平明显升高,并与脑梗死的体积大小、神经缺功能损程度、颈动脉粥样硬化狭窄程度有关,检测患者的血清IL-17含量可能有助于评价急性脑梗死的病情.

Objective To detect the serum levels of interleukin - 17 （ IL - 17 ） in patients with acute cerebral infarction （ ACI）, and to explore the role of IL - 17 in the pathogenesis of ACI. Methods The serum concentrations of IL -17 in patients with ACI were detected by enzyme -linked immunosorbent assay （ELISA） to compare with the normal control group. According to the sizes of infarction, the patients were divided into three groups： little size （ ≤4.0 cm^3） group, medium size （4.1 - 10.0 cm^3 ） group and large size （ 〉 10.0 cm^3 ） group; according to the National Institutes of Health Stroke Scale （NIHSS）, they were divided into three groups： low score （ 〈 4） group, medium score （4 - 15 ） group and high score （ 〉 15） group; and according to the degree of carotid stenosis, they were divided into three groups： low - grade stenosis （ 〈 50% ） group, medium - grade stenosis （50% - 70% ） group and high - grade stenosis （ 〉 70% ） group. Analyses were conducted on the relationships of the variations of IL - 17 levels with the sizes of infarction, clinical neurologic impairment degree scoring and the carotid atherosclerotie plaques. Results The serum levels of IL - 17 in the ACI groups were significantly higher than those in the normal control group （P 〈 0.01 ）. Comparisons between groups with the different infarction sizes also had significant differences （P 〈 0.05）, and serum levels of IL - 17 increased with the enlargement of infarction sizes; serum levels of IL - 17 in the neurologic impairment groups were markedly higher than those in the normal control group （ P 〈 0.01 ） and inter - group comparisons showed significant differences （ P 〈 0.05 or 〈 0.01 ）. IL - 17 levels were elevated with the rise of neurological impairment ; the serum levels of IL - 17 in the carotid atherosclerotic stenosis groups were evidently higher than those in the normal control group （P〈 0.01 ） and had significant differences between groups （P 〈 0.05 ）. IL - 17 levels increased with the rise in carotid stenosis degrees. Conclusion There is a significant increase in the serum levels of IL - 17 in patients with ACI, and it is closely correlated with volumes of infarction, severity of clinical neurologic impairment and degrees of carotid atherosclerotic stenosis. Determination of the serum level of IL - 17 of patients with ACI may contribute to the evaluation of the severity of ACI.