脑梗死急性期TNF-α和IL-6水平变化及临床意义

Change and its clinical significance of TNF-α and IL-6 in patients with acute ischemic stroke

目的探讨TNF-α和IL-6在脑梗死发病机制中的作用及临床意义。方法 ELISA法动态检测56例急性脑梗死患者的血清TNF-α和IL-6水平变化并作NIHSS和Barthel指数评分,另设40例年龄、性别与体重指数(BMI)相匹配的健康体检者作为对照。结果急性脑梗死组入院时(24h内)血清IL-6、TNF-α浓度显著增高,与对照组相比,差异有统计学意义(P<0.01);第3天达峰值水平,然后逐渐下降,至第28天时仍高于对照组(P<0.01);脑梗死患者入院第1天、第3天、第7天血清TNF-α、IL-6水平与同期NIHSS评分呈正相关,与Barthel指数呈负相关。结论急性脑梗死患者血清TNF-α和IL-6浓度变化与病情和预后密切相关;联合检测TNF-α和IL-6可评估急性脑梗死患者的病情及预后。

Objective To treat the change and clinical significance of Tumor necrosis factor-α （TNF-α） and Interleukin 6 （IL-6） in patients with acute ischemic stroke through dynamically assaying the serum concentration of TNF-α and IL-6. Methods Fifty-six patients with acute ischemic stroke （study group） were selected. The serum concentration of TNF-α and IL-6 were dynamically assayed, and the NIHSS and BI score were evaluated. In addition, 40 healthy age, gender, body mass index（BMI）-matched healthy subjects（control group） were evaluated. Results The serum concentration of TNF-α and IL-6 on admission in study group were higher than that in control group （P 〈 0.01）. They got to the peak on the third day, then decreased gradually. Pearson correlation analysis showed that the serum concentration of TNF-α and IL-6 in patients on admission, third day and seventh day were positively concerned with NIHSS scores （all P 〈 0.05） , whereas negatively concerned with BI （all P 〈 0.05）. Conclusion The serum concentration of TNF-α and IL-6 is associated with pathogenetic condition and outcome. Assaying the serum concentration of TNF-α combined IL-6 should be of importance as referred in- dexes.