急性脑梗死与血清炎症因子及颈动脉粥样硬化关系的研究

Analysis on relationship between the effect of serum inflammation factors and carotid sclerosis in actue cerebral infarction

目的观察颈动脉粥样硬化及血清炎症因子在脑梗死(cerebral infarct,CI)发病中的影响。方法收集2011年10月～2012年9月住院的急性期脑梗死(acute cerebral infarction,ACI)患者95例,并设正常对照组38例,观察脑梗死患者发病24 h内及2周末次日清晨血清白介素6(interleukin-6,IL-6)、超敏C反应蛋白(high sensi-tivity C reactive protein,hs-CRP)水平,同时通过彩色多普勒超声诊断仪检测颈动脉内膜厚度、颈动脉斑块性质。结果与对照组比较,ACI组血清IL-6及hs-CRP水平均增高(均有P<0.001),治疗2周后ACI患者IL-6较前降低(t=3.847,P=0.001)、hs-CRP较前降低(t=3.403,P=0.002);ACI患者中颈动脉内膜中层增厚组(A组)IL-6、hs-CRP水平较对照组均升高(均有P<0.001),B组及C组IL-6、hs-CRP水平高于A组(均有P=0.009)、B组较C组IL-6、hs-CRP水平升高(均有P=0.040),差异有统计学意义;与正常对照组比较,脑梗死患者颈动脉中层增厚、低回声斑块及强回声斑块均明显增多(均有P<0.001),且中灶脑梗组较腔梗组上述指标比较,差异有统计学意义(均有P=0.011)。结论颈动脉粥样硬化程度及IL-6、hs-CRP水平与脑梗死的发生呈正相关。

Objective To investigate the effect of serum inflammation factors and carotid sclerosis in acute cerebral infarction.Methods 95 patients with acute cerebral infarction from October 2011 to September 2012 were selected as the research group,and 38 normal people were selected as the control group.The serum interleukin 6 and high sesentive creactive protein levels in patients were observed in 24 hours and after 2 weeks.The carotid intima-media thickness and Carotid atherosclerotic plaques were also observed by Color doppler ultrasonic diagnostic instrument at the same time.Results Interleukin 6 level and high sensitivity c-reactive protein level were higher than the control group（P 0.001）.The indexes of patients were lower than before after two weeks treatment,the P value of IL-6 was 0.001 and the one of hs-CRP was 0.002;The serum interleukin 6 and high sesentive c-reactive protein levels of the carotid intima-media thickness group（A group） are higher than the control group（P 0.001）,the ones of the B group and C group were higher than the A group（P = 0.009）,the ones of the B group were higher than C group（P = 0.040）,and the differences were statistically significant;The number of the patients’carotid intima-media thickness,low echo plaques and strong echo plaques were more than the control group obviously,the ones in medium area of cerebral infarction group were more than the Lacunar cerebral infarction（P 0.001）,and the differences were all statistically significant（P = 0.011）.Conclusions The degree of carotid atherosclerosis and the levels of IL-6 and hs-CRP were positively related to the occurrence of cerebral infarction.