血浆凝血因子、IL-17水平与脑梗死相关性及预后的研究分析

The analysis on the relationships between plasma coagulation factor ,IL-17 levels and cerebral infarction

目的观察和分析血浆凝血因子(F)、白细胞介素17(IL-17)水平与急性脑梗死(ACI)相关性和早期预后的关系。方法选取100例ACI患者作为研究对象,根据其病灶大小将其分为大梗死组(病灶体积>10cm3,共纳入17例患者)、中梗死组(病灶体积为4-10cm3,共纳入28例患者)和小梗死组(病灶体积<4cm3,共纳入55例患者),同时选取同期体检结果正常的30例健康人作为对照组。在发病24h内和发病第14天时对ACI患者进行脑卒中NIHSS量表评分评定,并根据NIHSS评分变化评估其近期预后。检测三组ACI患者在发病后24h内、第3天、第7天、第14天和对照组的血浆F、IL-17水平。结果三组ACI患者在各观察时点的血浆F、IL-17水平均显著高于对照组(P<0.05),大梗死组患者在各观察时点的血浆F、IL-17水平均显著高于中梗死组或小梗死组(P<0.05),而中梗死组患者与小梗死组患者在各观察时点的血浆F水平的差异无显著性(P>0.05),中梗死组患者在各观察时点的血浆IL-17水平均显著高于小梗死组患者(P<0.05);大梗死组患者发病24h和第14天的NIHSS评分均显著高于中梗死组(P<0.05),中梗死组的评分均显著高于小梗死组(P<0.05);大梗死组患者中近期预后为"显著进步"的比例显著低于中梗死组(P<0.05),中梗死组患者中近期预后为"显著进步"的比例显著低于小梗死组(P<0.05),ACI患者的血浆F水平(r=0.348)和IL-17水平(r=0.371)与NIHSS评分呈正相关。结论血浆F、IL-17水平的升高可能是ACI发病的相关因素,且与患者梗死病灶的大小、神经功能损伤程度和近期预后情况具有相关性,可作为评估病情和预测近期预后的辅助指标。

Objective To observe and analyze the relationships between plasma coagulation factor XIII （F XIII）and interleukin 17（IL-17）levels and the early prognosis of acute cerebral infarction （ACI）.Methods 100 cases of ACI pa-tients were selected as the research objects and divided into the large infarction group （lesion volume ＆gt;10 cm3 ,17 pa-tients included）,the medium infarction group （lesion volume was 4-10 cm3 ,28 patients included）and the small infarc-tion group （lesion volume〈4 cm3 ,55 cases included）according to the size of the lesions.At the same time,30 cases of healthy persons with normal physical examination results were selected as the control group.The NIHSS scores of the patients with ACI within 24 h and at 14th after the incidence were assessed,and the short-term prognosis was evaluated according to the changes of NIHSS scores.The plasma F XIII,IL-17 levels of the patient with ACI within 24 h and at 3rd,7th,14th and the level the objects in the control group at the day of examination were detected and compared.Re-sults The plasma F XIII,IL-1 7 levels of the patients with ACI at each observation point were were significantly higher than those in the control group（P〈0.05）.The plasma F XIII,IL-17 levels of the patients in the large infarction group at each observation point were significantly higher than those of the medium infarction group or the small infarction group （P〈0.05）,the difference of plasma F XIII level of the patients between the medium infarction group and the small infarction group at each observation point was not significant（P＆gt;0.05）,and plasma IL-17 levels of the patients with in the medium infarction group at each observation point were significantly higher than those of the small infarc-tion group （P〈0.05）;the NIHSS scores of the patients in the large infarction group within 24 h and at 14th day after the incidence were significantly higher than those of the medium infarction group （P〈0.05）,the scores of the medium infarction group were significantly higher than those of the small infarction group（P〈0.05）;the proportion of the pa-tients with early prognosis of“significant progress”in the large infarction patients was significantly lower than that in the medium infarction group （P〈0.05）,and such proportion of the patients in the medium infarction group was signifi-cantly lower than that of the small infarction group （P〈0.05）.The plasma F XIII level （r=0.348）and IL-17 level （r=0.371）was positively correlated with the NIHSS scores of the patients with ACI.Conclusion The elevated plasma F XIII,IL-1 7 levels may be the relevant factors in the pathogenesis of ACI.The levels may be correlated with the infarc-tion size,degree of nerve function inj ury and the early prognosis of the patients and can be used as the auxiliary indexes in evaluation of disease and prediction of short-term prognosis.