高血压合并急性脑梗死患者血清细胞因子及同型半胱氨酸与脑梗死的关系

The relationship among cytokines and homocysteine in acute cerebral infarction patients complicating with hypertension

目的探讨高血压合并急性脑梗死患者中细胞因子(ICAM-1、M-CSF、ox-LDL等)及Hcy与脑梗死的关系,为进一步明确细胞因子、氧化修饰低密度脂蛋白、同型半胱氨酸与高血压合并急性脑梗死发病机制的关系提供依据。方法选取2015-01—2016-01脑梗死住院患者100例(其中高血压合并急性脑梗死患者50例,非高血压性急性脑梗死患者50例)及体检中心正常对照者100例,抽血检验血脂、血糖、肝肾功能等,测定血清同型半胱氨酸,应用酶联免疫吸附测定法(ELISA)检测oxLDL、sICAM-1、M-CSF,彩色超声检测双侧颈动脉等并进行对比分析。结果高血压合并急性脑梗死组较对照组M-CSF、oxLDL、sICAM-1、Hcy水平均高,差异均有统计学意义(P<0.01);Hcy与急性脑梗死相关细胞因子的Pearson相关性分析提示,M-CSF、ox-LDL、sICAM-1与Hcy无显著关联性(P>0.05)。结论细胞因子M-CSF、ox-LDL、sICAM-1及同型半胱氨酸在导致高血压患者动脉粥样硬化导致脑梗死过程中可能起重要作用;高同型半胱氨酸血症(HHcy)可能是导致脑梗死患者sICAM-1不同程度升高的原因之一,同时在导致动脉粥样硬化致脑梗死过程中可能起独立致病作用。

Objective To investigate the differences and relationship among soluble intercellular adhesion molecule-l（sI- CAM-1 ）, macrophage colony-stimulating factor（M-CSF）, oxidative modification of low density lipoprotein（ox-LDL） and homocysteine （Hcy）in diabetes with acute cerebral infarction,for further understanding the pathogenesis of cytokines and homocysteine in acute cerebral infarction with hypertension. Methods One hundred acute cerebral infarction inpatients from January 2015 to January 2016 were enrolled. The patients were divided into two subgroups A and B according to whether with hypertension mellitus or not,each group included 50 cases. One hundred healthy cases were selected as control group from the department of physical examination. Serum level of lipids,glucose, homocysteine, liver and kidney function indexes were recorded. The ox-LDI., sICAM-1, and M-CSF were measured by using the enzyme-linked immunosorbent assay（ELISA）. The color Doppler ultrasound was used to detect carotid artery. Results Compared with the control group, the level of M-CSF ox-LDL, slCAM-1, Hcy in hypertension patients with acute cerebral infarction group were all higher,differences were statistically significant（P〈0.01） ;Hcy and acute cerebral infarction associated cytokines Pearson correlation correlation analysis showed, M-CSF,ox-LDL, sICAM-1 had no significant correlations with Hcy（P〉0.05）. Conclusion M-CSF,ox-LDL,sICAM-1 and homocysteine in the hypertension patients may play important roles in the artery atherosclerosis leading to cerebral infarction process. Homocysteine may play a synergistic effect in atherosclerosis process.