白细胞介素17、白细胞介素23在颈动脉粥样硬化脑梗死患者血清中的表达及意义

Expression and significance of the interleukin-17,interleukin-23 in serum of carotid athery sclerosis in patients with cerebral infarction

目的 了解白细胞介素17（IL-17）、白细胞介素23 （IL-23）与脑梗死患者颈动脉硬化的相关性.方法 2010年6月至2012年6月收集的脑梗死患者125例为研究对象.所有患者行颈动脉超声检查及血清IL-17及IL-23检查.根据颈动脉超声检查是否检出斑块,分为颈动脉硬化组（86例）与非颈动脉硬化组（39例）.颈动脉硬化的患者按其斑块性质进行分组,可分为软斑块组（35例）、硬斑块组（21例）、混合性斑块组（30例）；颈动脉硬化脑梗死患者的斑块采用半定量法,按严重程度分组,分为Ⅰ级（29例）、Ⅱ级（43例）、Ⅲ级（14例）.结果 颈动脉硬化组与非颈动脉硬化组IL-17和IL-23比较,差异均有统计学意义[IL-17：（31.42±8.73） μg/L与（22.81±6.52） μg/L,t=5.15,P＜0.01；IL-23：（21.79±9.34） μg/L与（14.33±6.21） μg/L,t=4.99,P＜0.01].软斑块、硬斑块、混合性斑块组IL-17和IL-23比较,差异均有统计学意义（F值分别为10.181、3.835,P均＜0.05）,且软斑块组和混合性斑块组患者血清IL-17表达高于硬斑块组（P =0.001；P =0.007）,软斑块组患者血清IL-23表达高于混合性斑块组和硬斑块组（P =0.017;P =0.045）.按斑块严重程度所分Ⅰ、Ⅱ、Ⅲ级组IL-17和IL-23比较,差异均有统计学意义（F值分别为41.046、3.739,P均＜0.05）,且Ⅱ、Ⅲ级与Ⅰ组比较差异均有统计学意义（P＜0.01,P＜0.05）,并存在相关性（r=0.892,P=0.000;r =0.420,P=0.041）.结论 IL-17和IL-23参与动脉硬化的发生、发展,早期发现并干预对预防脑梗死的发生有一定的作用.

Objective To investigate the relationship between the interleukin-17 （IL-17）,interleukin23 （IL-23） and carotid artery sclerosis in patients with cerebral infarction.Methods One hundred and twentyfive cerebral infarction patients in the first affiliated hospital of Shantou University medical college from June 2010 to June 2012 were recruited.All the subjects were examined with carotid ultrasonography.According to the results of carotid ultrasonography,all patients were divided into carotid atherosclerosis group（86 cases） and non carotid atherosclerosis group（39 cases）.Patients with carotid atherosclerosis were divided into soft plaque group （35 cases）,hard plaque group （21 cases）,mixed plaque group （30 cases） based on plaque feature.Carotid atherosclerosis patients with cerebral infarction plaque determined by semi-quantitative method were grouped into Ⅰ grade（29 cases）,Ⅱ grade （43 cases）,Ⅲ grade （14 cases） according to the severity atherosclerosis.Serum levels of IL-17 and IL-23 were measured.Results The levels of IL-17 and IL-23 in patients with carotid atherosclerosis group were （31.42 ± 8.73） μg/L and（21.79 ± 9.34） μg/L,higher than that of non-carotid atherosclerosis group（（22.81 ±6.52） μg/L,t =5.15,P ＜0.01 ; （14.33 ±6.21） μg/L,t =4.99,P ＜0.01）.The IL-17 and IL-23 levels in patients with soft plaque,hard plaque and mixed plaque group were significant different （F =10.181,3.835,P ＜0.05）.Serum IL-17 in soft plaque and mixed plaque expression group was higher than that of hard plaque group （P =0.001,P=0.007）.IL-23 level in soft plaque group was higher than mixed plaque and hard plaque groups（P =0.017;P =0.045）.The IL-17 and IL-23 levels in Ⅰ,Ⅱ,Ⅲ level group were markedly different （F =41.046,3.739 ; P ＜ 0.05）,and there was significant difference between Ⅱ,Ⅲ and Ⅰ group（P ＜0.01,P ＜0.05）.The correlation between IL-17 and IL-23 levels in Ⅰ,Ⅱ,Ⅲ level group were 0.892 and 0.420 （P =0.000 ; P =0.041）.Conclusion IL-17 and IL-23 play important roles in the pathologic progress of artery sclerosis and are helpful for early diagnosis of the disease.