炎性细胞因子在急性缺血性脑梗死尿激酶静脉溶栓治疗患者中的变化

Study on the changes of inflammatory cytokines in patients with acute ischemic cerebral infarction after urokinase thrombolytic treatment

目的探讨炎性细胞因子在急性缺血性脑梗死(ACI)尿激酶静脉溶栓治疗患者中的变化。方法选取收治的ACI尿激酶静脉溶栓治疗患者100例为ACI组,同期选取健康人员30例为健康组,采用免疫比浊法检测血清[白介素10(IL-10)、白介素6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平,分析炎性细胞因子在患者治疗前后的变化情况。结果 ACI组血清IL-10、IL-6、TNF-α水平明显高于健康组,差异有统计学意义(P <0. 05); ACI组治疗后血清IL-10、IL-6、TNF-α水平和美国国立卫生研究院卒中量表(NIHSS)评分明显低于治疗前,差异有统计学意义(P <0. 05);Pearson相关性分析显示,血清IL-10、IL-6、TNF-α水平与NIHSS评分呈正相关(P <0. 05);随访12个月期间,再发缺血性脑梗死患者20例(20. 00%),再发患者血清IL-10、IL-6、TNF-α水平明显高于无再发患者,差异有统计学意义(P<0. 05)。结论 IL-10、IL-6、TNF-α等炎性细胞因子与ACI的发生及病情转归、预后有关,监测其在尿激酶静脉溶栓治疗前后的水平变化,对评估患者病情转归、预后和指导治疗具有重要的参考价值,值得临床进一步推广。

Objective To investigate the changes of inflammatory cytokines in patients with acute ischemic cerebral infarction(ACI) after urokinase thrombolytic treatment. MethodsA total of 100 patients with ACI who were treated by urokinase thrombolysis in our hospital from September 2008 and December 2012 were enrolled as ACI group,at the same time, the other 30 healthy subjects were enrolled as control group.The serum levels of interleukin 10 (IL-10),interleukin 6 (IL-6),tumor necrosis factor-alpha (TNF-alpha) were detected by immunoturbidimetry to analyze the changes of inflammatory cytokines before and after the treatment. ResultsThe serum levels of IL-10,IL-6 and TNF-alpha in ACI group were significantly higher than those in control group ( P <0.05).After treatment,the serum levels of IL-10,IL-6,TNF-alpha and the National Institutes of Health Stroke Scale (NIHSS) in ACI group were significantly lower than those before treatment ( P < 0.05 ).The Pearson correlation analysis showed that the serum levels of IL-10,IL-6 and TNF-alpha were positively correlated with the NIHSS score ( P <0.05).During 12-month follow up,there were 20 cases of ischemic cerebral infarction (20%),the serum levels of IL-10,IL-6 and TNF-alpha in the recurrent patients were significantly higher than those in the non recurrent patients ( P <0.05). ConclusionThe IL-10,IL-6,TNF-alpha and other inflammatory cytokines are related to the occurrence and prognosis of ACI,and it is important to monitor the changes of the serum levels of urokinase before and after thrombolytic treatment,which has important reference value for assessing the prognosis of patients and directing treatment,thus, it is worthy of further promotion in clinical practice.