炎性因子与急性脑梗死多因素的相关性研究

Study of Correlation between Inflammatory Factors and Multiple Factors of Acute Cerebral Infarction

目的观察超敏C反应蛋白(hs CRP)、白细胞介素(IL)-18、细胞间黏附分子-1(ICAM1)、基质金属蛋白酶(MMP)-9、脂蛋白相关磷脂酶A2(Lp-PLA2)血清水平变化与急性脑梗死多因素的关系。方法选择2012年7月-2014年6月收治的76例急性脑梗死患者作为研究对象。于患者发病第2天(急性期)及第15天(恢复期)检测血清hs CRP、IL-18、ICAM1、MMP-9、Lp-PLA2水平,采用多重线型回归模型分别观察炎性因子的变化程度与高血压病、糖尿病、冠状动脉粥样硬化性心脏病、吸烟史、颈部血管斑块、低密度脂蛋白、脑梗死面积、美国国立卫生研究院卒中量表(NIHSS)评分的关系。结果急性脑梗死患者急性期与恢复期各炎性因子变化水平与吸烟史、高血压、冠状动脉粥样硬化性心脏病、低密度脂蛋白、NIHSS评分无明显相关(P>0.05);hs CRP、ICAM1动态变化与脑梗死面积、糖尿病、颈动脉粥样硬化相关(P<0.05),Lp-PLA2的水平变化与脑梗死面积、颈动脉粥样硬化有明显相关性(P<0.05),IL-18动态变化与糖尿病、颈动脉粥样硬化相关(P<0.05),而MMP-9仅与脑梗死面积相关(P<0.05)。结论炎性因子血清水平变化与脑梗死患者的多种因素有关,其中梗死面积、糖尿病、颈动脉粥样硬化是影响其血清水平变化的主要因素。

ObjectiveTo observe the relationship between the serum level changes of high-sensitivity C-reactive protein （hsCRP）, interleukin （IL）-18, intercellular adhesion molecule-1（ICAM1）, matrix metalloproteinase （MMP）-9 and lipoprotein-associated phospholipase A2（Lp-PLA2）, and the multiple factors of acute cerebral infarction （ACI）. MethodsWe chose 76 patients with ACI treated between July 2012 and June 2014 as our study subjects.On the second day （acute phase） and the 15th day （recovery phase） after onset, we checked the patients for their serum levels of hsCRP, IL-18, ICAM1, MMP-9 and Lp-PLA2.Then, multiple linear regression analysis was performed to observe the correlation of the serum level change degree of inflammatory factors with hypertension, diabetes, coronary heart disease, smoking history, carotid atherosclerotic plaque, lipid levels, infarct size and National Institute of Health Stroke Scale （NIHSS） score. ResultsThe changes of all the inflammatory factors in the acute phase and the recovery phase of cerebral infarction were not significantly related to smoking history, hypertension, coronary heart disease, low-density lipoprotein and NIHSS scores （P 〉 0.05）.The changes of hsCRP and ICAM1 had significant correlation with cerebral infarct size, diabetes mellitus and carotid atherosclerotic plaque （P 〈 0.05）, and the change level of Lp-PLA2 was related to diabetes mellitus, and carotid atherosclerotic plaque （P 〈 0.05）.MMP-9 serum level change had correlation with only cerebral infarct size （P 〈 0.05）. ConclusionsSerum level changes of inflammatory factors are related to various factors of cerebral infarction.The main factors that affecting the serum level changes are cerebral infarction area, diabetes mellitus and carotid atherosclerosis.