摘要
目的探讨急性缺血性脑卒中患者血浆趋化因子12(CXC chemokine ligand-12,CXCL-12)、白细胞介素-33(interleukin-33,IL-33)、泛素羧基末端水解酶-1(ubiquitin carboxyl-terminal hydrolase-L1,UCH-L1)水平变化,及其与病情严重程度、预后的关系。方法急性缺血性脑卒中患者89例为观察组,依据美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分分为轻度患者27例、中度患者42例,重度患者20例;患者入院后均给予抗血小板聚集、改善侧支循环等常规处理或溶栓治疗,并依据改良Rankin量表(modified Rankin scale,mRS)评分分为预后良好组46例和预后不良组43例;同期60例体检健康者为对照组。采用ELISA法检测观察组和对照组入院时血浆CXCL-12、IL-33及UCH-L1水平,并进行比较;Spearman法分析血浆CXCL-12、IL-33及UCH-L1与NIHSS评分、mRS评分的相关性。结果观察组入院时血浆CXCL-12[(7.47±1.71)ng/L]、IL-33[(62.91±11.33)ng/L]及UCH-L1[0.17(0.09,0.23)μg/L]水平均高于对照组[(3.24±1.29)ng/L、(34.26±9.45)ng/L、0.06(0.03,0.11)μg/L](P<0.05);观察组轻、中、重度患者血浆CXCL-12[(5.61±0.75)、(7.61±0.58)、(9.70±1.38)ng/L]、UCH-L1[0.12(0.07,0.18)、0.18(0.13,0.22)、0.25(0.23,0.29)μg/L]水平均逐渐升高(P<0.05),血浆IL-33水平在轻度患者[(66.29±10.55)ng/L]、中度患者[(64.05±11.60)ng/L]均高于重度患者[(58.64±10.52)ng/L](P<0.05),轻度患者与中度患者比较差异无统计学意义(P>0.05);预后良好组血浆CXCL-12[(6.21±0.93)ng/L]、UCH-L1[0.16(0.09,0.20)μg/L]水平均低于预后不良组[(8.23±1.26)ng/L、0.22(0.13,0.26)μg/L],血浆IL-33[(65.23±11.49)ng/L]水平高于预后不良组[(60.43±10.72)ng/L](P<0.05);Spearman相关分析结果显示,观察组血浆CXCL-12、UCH-L1与NIHSS评分(r=0.794,P<0.001;r=0.638,P<0.001)及mRS评分(r=0.422,P<0.001;r=0.215,P=0.043)均呈正相关,血浆IL-33与NIHSS评分(r=-0.289,P=0.006)和mRS评分(r=-0.256,P=0.015)均呈负相关。结论急性缺血性脑卒中患者血浆CXCL-12、IL-33及UCH-L1水平均升高,且与病情严重程度及预后密切相关。
Objective To explore the changes of plasma CXC chemokine ligand-12(CXCL-12),interleukin-33(IL-33)and ubiquitin carboxyl-terminal hydrolase-1(UCH-L1)level in patients with acute ischemic stroke(AIS)and their correlations with the severity and prognosis of AIS.Methods Eighty-nine patients with AIS(observation group)were randomly divided mile group(n=27),moderate group(n=42)and severe group(n=20)according to the National Institutes of Health Stroke Scale(NIHSS)scores,and all received routine treatment and thrombolytic therapy as antiplatelet aggregation and improving collateral circulation.The patients were redivided into good prognosis group(n=46)and poor prognosis group(n=43)according to modified Rankin scale(mRS)score.Another 60 healthy volunteers were as controls(control group).The levels of plasma CXCL-12,IL-33 and UCH-L1 were detected by ELISA method and compared among groups.And the correlations of plasma CXCL-12,IL-33 and UCH-L1 with NIHSS and mRS scores were analyzed with Spearman correlation coefficients.Results The level of plasma CXCL-12((7.47±1.71)ng/L),IL-33((62.91±11.33)ng/L)and UCH-L1(0.17(0.09,0.23)μg/L)in observation group were significantly higher than those in control group((3.24±1.29)ng/L,(34.26±9.45)ng/L,0.06(0.03,0.11)μg/L)at admission(P〈0.05).The levels of plasma CXCL-12((5.61±0.75),(7.61±0.58),(9.70±1.38)ng/L),UCH-L1(0.12(0.07,0.18),0.18(0.13,0.22),0.25(0.23,0.29)μg/L)in mild,moderate and severe groups increased gradually(P〈0.05).The level of IL-33 was significantly higher in mild group((66.29±10.55)ng/L)and moderate group((64.05±11.60)ng/L)than that in severe group((58.64±10.52)ng/L)(P〈0.05),and there was no significant difference between mild and moderate groups(P〉0.05).The levels of plasma CXCL-12((6.21±0.93)ng/L)and UCH-L1(0.16(0.09,0.20)μg/L)in good prognosis group were significantly lower than those in poor prognosis group((8.23±1.26)ng/L,0.22(0.13,0.26)μg/L),and the level of IL-33((65.23±11.49)ng/L)in good prognosis group was significantly higher than that in poor prognosis group((60.43±10.72)ng/L)(P〈0.05).Spearman correlation analysis showed the levels of plasma CXCL-12 and UCH-L1 were positively correlated with NIHSS score(r=0.794,P〈0.001;r=0.638,P〈0.001)and mRS score(r=0.422,P〈0.001;r=0.215,P=0.043),and the IL-33 level was negatively correlated with NIHSS score(r=-0.289,P=0.006)and mRS score(r=-0.256,P=0.015).Conclusion The plasma levels of CXCL-12,IL-33 and UCH-L1 increase in patients with AIS and are closely correlated with the severity and prognosis of AIS.
作者
程启慧
CHENG Qi-hui(Department of Neurology, Haikou People's Hospital, Haikou 570208, Chin)
出处
《中华实用诊断与治疗杂志》
2018年第7期657-660,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
海南省自然科学基金(20158272)