脑梗死患者血清可溶性CD40L、白介素-18水平的变化及意义

Changes and its significance of the levels of serum soluble CD40L and interleukin-18 in cerebral infarction patients

目的探讨脑梗死患者的血清可溶性CD40L(sCD40L)、白介素-18(IL-18)水平的变化及意义。方法采用酶联免疫吸附法测定40例腔隙性脑梗死患者(腔梗组)、40例脑梗死患者(脑梗死组)和38名正常对照者(NC组)的血清sCD40L、IL-18水平,并对脑梗死患者进行颈动脉超声检查及美国国立卫生研究院卒中量表(NIHSS)评分。结果与正常对照组比较,腔梗组及脑梗死组血清sCD40L及IL-18显著升高(均P<0.01);且脑梗死组显著高于腔梗组(均P<0.01)。中、重度脑梗死患者的血清sCD40L及IL-18水平显著高于正常对照组及轻度脑梗死患者(P<0.05～0.01)。与内膜正常患者比较,有稳定斑块及不稳定斑块患者的血清sCD40L及IL-18水平显著升高(均P<0.01),内膜增厚患者IL-18水平显著升高(P<0.05)。与内膜增厚患者比较,有稳定斑块患者的血清sCD40L水平和有不稳定斑块患者的血清sCD40L及IL-18水平显著升高(均P<0.01)。有不稳定斑块患者的血清sCD40L及IL-18水平显著高于有稳定斑块的患者(均P<0.01)。脑梗死患者血清sCD40L水平与IL-18水平呈正相关(r=0.729,P<0.01)。结论脑梗死患者血清sCD40L、IL-18水平显著升高,并能反映颈动脉粥样硬化程度及脑梗死病情。

Objective To observed the changes and its significance of the levels of serum soluble CIMOL ligand （sCD40L） and interleukin-18 （IL-18） in cerebral infarction patients. Methods The levels of serum sCD40L and IL-18 in 40 lacunar infarction patients （lacunar infarction group）, 40 cerebral infarction patients （cerebral infarction group） and 38 normal controls （NC group） were detected by enzyme-linked immunosorbent assay. All of the patients were also received carotid artery ultrasound examination and United States National Institutes of Health Stroke Scale （NIHSS） score. Results Compared with NC group, the levels of serum sCIMOL and IL-I 8 in lacunar infarction group and cerebral infarction group were significantly increased （ all P 〈 0. 01 ） ; and those in cerebral infarction group were significantly higher than those in lacunar infarction group （ all P 〈 0.01 ）. The levels of serum sCD40L and IL- l8 in medium and severe cerebral infarction patients were significantly higher than NC group and mild cerebral infarction patients （ P 〈 0. 05 - 0.01 ）. Compared with normal endometrium patients, the levels of serum sCIMOL and IL-18 in patients with stable plaque and unstable plaque were significantly increased （ all P 〈 0. 01 ）, the levels of serum IL-18 in intimal thickening patients were significantly increased （P 〈0. 05）. Compared with intimal thickening patients, the levels of serum sCIMOL in patients with stable plaque and the levels of serum sCD40L and IL-18 in patients with unstable plaques were significantly increased （ all P 〈 0. 01 ）. There was a positive correlation between the levels of serum sCD40L and IL-18 in cerebral infarction patients （ r = 0. 729, P 〈 0. 01 ）. Conclusion The levels of serum sCD40L, IL-18 in cerebral infarction patients are significantly increased, which can reflect the severity of carotid atherosclerosis and the condition of cerebral infarction.