进展性脑梗死患者凝血指标、炎症细胞因子的变化及临床意义

Significance and changes of coagulation indexes and inflammatory cytokines in patients with progressive cerebral infarction

目的分析比较进展性脑梗死患者血清炎症细胞因子及凝血指标的变化及临床意义。方法以脑梗死患者及健康人群作为研究对象，按患病类型分三个研究组，即非进展性脑梗死组（NPCI组），进展性脑梗死组（PCI组）和健康人群对照组，每组60例，并分别检测所有研究对象血清白细胞介素-18（IL-18）、肿瘤坏死因子-α（TNF-α）及凝血指标的表达水平。结果PCI组患者血清中IL-18、TNF-α及纤维蛋白原（Fib）的表达水平均显著高于NPCI组及对照组，组间比较差异有统计学意义（P〈0.05或P〈0.01）；NPCI组研究对象在入院第14天时TNF-α的浓度与对照组相比差异未见统计学意义（P〉0.05）。PCI组患者血清中凝血指标如凝血酶原时间（PT）、部分凝血活酶时间（APTT）及凝血酶时间（TT）的表达水平分别为（8.44±1.61）、（26.51±2.75）及（8.26±1.39）ng/mL，均显著低于NPCI组及健康对照组，组间比较差异有统计学意义（P〈0.05或P〈0.01）。结论凝血相关指标及炎症细胞因子IL-18、TNF-α可作为评估进展性脑梗死严重程度的一种参考因素，并在一定程度上提示进展性脑梗死患者的病情和预后。

ObjectiveTo analyze the serum levels of coagulation and inflammatory cell factors in patients with progressive cerebral infarction and its significance.MethodsThe patients with progressive cerebral infarction（progressive cerebral infarction group）, the patients with non-progressive cerebral infarction（non progressive cerebral infarction group） and the healthy individuals（control group） were selected as the research objects. Sixty individuals were included in each group.The levels of IL-18, TNF-α and coagulation of the research objects were detected and observed.ResultsThe levels of IL-18, TNF-α and fibrinogen of the progressive cerebral infarction group were significantly higher than those of non-progressive cerebral infarction group and the control group（P〈0.05 or P〈0.01）. However, there was no significantly difference in the level of TNF-α between non-progressive cerebral infarction group and the control group at the time of 14 days（P〉0.05）. The serum PT, APTT and TT levels in patients with progressive cerebral infarction were（8.44±1.61）, （26.51±2.75） and（8.26±1.39）ng/ml, which was significantly decreased than those of the non progressive cerebral infarction group and healthy control group, there were significant differences （P〈0.05 or P〈0.01）.ConclusionsThe coagulation indexes and the inflammatory factors such as IL-18, TNF-α can be indicators for assessment of progressive cerebral infarction severity, which suggests patient’s condition and prognosis at a certain extent.