超敏C-反应蛋白、白细胞介素18与青年缺血性脑卒中后焦虑的相关性

Study on IL-18 and hs-CRP in young patients with post-stroke anxiety

目的探讨血清超敏C-反应蛋白(hypersensitive C-reactive protein,hs-CRP)、白细胞介素-18(interleukin-18,IL-18)水平与青年缺血性脑卒中后焦虑的关系。方法选取首次发病的确诊的青年缺血性脑卒中患者49例(脑卒中组),以健康体检者53例为健康对照(对照组),分别于入院后1d、7d、14d和21d检测hs-CRP及IL-18水平,3周后使用汉密尔顿焦虑量表对患者进行焦虑评分。根据该评分将患者分为脑卒中后焦虑组和脑卒中后非焦虑组,比较脑卒中组与对照组及脑卒中后焦虑组与非焦虑组hs-CRP及IL-18水平的差异。结果脑卒中组hs-CRP水平在入院1d〔(9.55±2.53)mg/L vs.(1.25±0.18)mg/L,t=22.89,P=0.008〕、7d〔17.31±4.83)mg/L vs.(0.78±0.23)mg/L,t=23.92,P=0.005〕、14d〔(15.56±3.67)mg/L vs.(1.34±0.30)mg/L,t=27.10,P=0.007〕、21d(13.28±2.96)mg/L vs.(0.85±0.34)mg/L,t=21.90,P=0.003〕均高于对照组。脑卒中后焦虑组hs-CRP水平在入院7d〔(19.43±2.17)mg/L vs.(14.56±1.83)mg/L,t=8.38,P=0.004〕、14d〔(17.85±2.75)mg/L vs.(13.21±2.94)mg/L,t=5.45,P=0.001〕和21d〔(14.08±1.86)mg/L vs.(9.78±2.67)mg/L,t=6.02,P=0.003〕时高于脑卒中后非焦虑组。与对照组比较,脑卒中组血清IL-18水平在入院7d〔(19.68±3.23)mg/L vs.(17.34±1.86)mg/L,t=4.32,P=0.006〕、14d〔(22.68±2.65)mg/L vs.(16.68±2.48)mg/L,t=11.53,P=0.002〕和21d〔(27.74±4.96)mg/L vs.(15.74±3.12)mg/L,t=14.03,P=0.001〕时均升高。脑卒中后焦虑组IL-18水平在入院7d〔(21.77±3.56)mg/L vs.(18.85±3.44)mg/L,t=2.82,P=0.007〕、14d〔(25.57±2.54)mg/L vs.(22.13±2.71)mg/L,t=4.15,P=0.002〕和21d〔(29.35±4.14)mg/L vs.(26.79±4.98)mg/L,t=4.15,P=0.002〕时高于非焦虑组。在7d、14d、21d时,焦虑组与非焦虑组患者炎性因子hs-CRP、IL-18水平均明显高于对照组(均P<0.01)。结论脑卒中后焦虑可能与hs-CRP、IL-18高水平有关。

Objective To investigate the correlation between interleukin-18（IL-18）,hypersensitive Creactive protein（hs-CRP）and post-stroke anxiety in young ischemic stroke patients. Methods Forty-nine young patients with first-onset definite ischemic stroke and 53 healthy controls were selected.They were divided into three groups after assessed by Hamilton Anxiety Scale（HAMA）,including the healthy control,anxiety and non-anxiety group.Serum levels of IL-18 and hs-CRP were detected in all objects at 1d,7d,14 dand 21dafter admitted to hospital respectively.Levels of IL-18 and hs-CRP were compared among three groups.Results At 1d,7d,14 dand 21dafter admitted to hospital,the serum levels of hs-CRP in the ischemic stroke group[（9.55±2.53）,（17.31±4.83）,（15.56±3.67）,（13.28±2.96）mg/L]were significantly higher than those of the healthy control group[（1.25±0.18）,（0.78±0.23）,（1.34±0.13）,（0.85±0.34）mg/L]（t=22.89,P=0.008;t=23.92,P=0.005;t=27.10,P=0.007;t=21.90,P=0.003,respectively）.At 7d,14 dand 21d,the serum levels of hs-CRP in the anxiety group[（19.43±2.17）,（17.85±2.75）,（14.08±1.86）mg/L]were significantly higher than those of the non-anxiety group[（14.56±1.83）,（13.21±2.94）,（9.78±2.67）mg/L]（t=8.38,P=0.004;t=5.45,P=0.001;t=6.02,P=0.003,respectively）.At 7d,14 dand 21d after admitted to hospital,the serum levels of IL-18 in the anxiety group [（21.77±3.56）,（25.57±2.54）,（29.35±4.14）mg/L]were significantly higher than those of the non-anxiety group[（18.85±3.44）,（22.13±2.71）,（26.79±4.98）mg/L]（t=2.82,P=0.007;t=4.15,P=0.002;t=4.15,P=0.002,respectively）.At 7d,14 dand 21d,the serum levels of IL-18 in the ischemic stroke group[（19.68±3.23）,（22.68±2.65）,（27.74±4.96）mg/L]were significantly higher than those of the healthy control group[（17.34±1.86）,（16.68±2.48）,（15.74±3.12）mg/L]（t=4.32,P=0.006;t=11.53,P=0.002;t=14.03,P=0.001,respectively）.Serum levels of hs-CRP and IL-18 in the anxiety and non-anxiety group both increased compared with the healthy control group at 7d,14 dand 21dafter admitted to hospital（P〈0.01）.Conclusions Higher serum levels of hs-CRP and IL-18 were closely related to the post-stroke anxiety in young patients with ischemic stroke.