急性脑梗死神经功能恢复与炎症因子的关系

Correlation of neurological function recovery with inflammatory factors in acute cerebral infarction patients

目的探讨急性脑梗死炎症因子和神经功能恢复的关系。方法临床选择2016年5月至2017年7月在十堰市太和医院神经内科就诊的90例急性脑梗死患者作为观察组,根据脑梗死面积大小分为大梗死组(n=46)和中小梗死组(n=44),同期选择体检健康者60例作为对照组,检测并比较所有研究对象的N末端脑钠素原(NT-proBNP)、同型半胱氨酸(Hcy)、基质金属蛋白酶-9(MMP-9)、可溶性细胞间黏附分子1(sICAM-1)、肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)等血清炎性因子水平;比较大梗死组和中小梗死组患者的血清炎性因子水平;采用Pearson法分析急性脑梗死患者的炎性因子与脑梗死体积和神经功能恢复的相关性。结果观察组患者的NT-proBNP、Hcy、MMP-9、sICAM-1、TNF-α、IL-1β等血清炎性因子水平分别为(430.4±30.7)pg/mL、(20.5±7.6)μmol/L、(160.4±46.3)μg/L、(480.6±70.6)μg/L、(4.3±0.6)μg/L、(4.0±2.4)μg/L,分别与健康对照组的(56.8±8.7)pg/mL、(13.4±5.3)μmol/L、(86.9±15.5)μg/L、(340.7±64.3)μg/L、(2.5±0.1)μg/L、(2.6±0.1)μg/L比较,观察组均高于对照组,差异均有统计学意义(P<0.05);大梗死组患者的NT-proBNP、Hcy、MMP-9、sICAM-1、TNF-α、IL-1β等血清炎性因子水平分别为(544.4±60.7)pg/mL、(24.5±8.6)μmol/L、(240.4±43.3)μg/L、(593.6±70.6)μg/L、(4.7±0.6)μg/L、(4.6±0.4)μg/L,分别与中小梗死组的(356.8±48.7)pg/mL、(16.5±4.9)μmol/L、(123.9±35.5)μg/L、(440.7±67.3)μg/L、(3.5±0.2)μg/L、(3.1±0.1)μg/L比较,大梗死组均高于中小梗死组,差异均有统计学意义(P<0.05);急性脑梗死的血清炎性因子水平均与脑梗死的体积和脑神经缺损程度呈正相关(r=0.54、0.33,P<0.01)。结论急性脑梗死的血清炎性因子水平与脑梗死的梗死病灶大小、脑神经缺损程度呈正相关。

Objective To study the correlation of inflammatory factors with neurological function recovery in acute cerebral infarction(ACI)patients.Methods A total of 90 ACI patients,who treated in Department of Neurology of Shiyan Taihe Hospital from May 2016 to July 2017,were selected as the observation group.According to the infarction area,the patients were classified into the large area group(n=46),middle and small area group(n=44).At the same time,60 health check-ups were selected as the control group.The serum inflammatory factors like N-terminal pro-B-type natriuretic peptide(NT-proBNP),homocysteine(Hcy),matrix metalloproteinase-9(MMP-9),soluble intercellular adhesion molecule-1(sICAM-1),tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)were detected.The serum inflammatory factors among the ACI patients and health check-ups,large area group and middle and small area group were compared.The Pearson methods were used to analyze its correlation of inflammatory factors,infarction area,and neurological function recovery conditions.Results The serum inflammatory factors like NT-proBNP,Hcy,MMP-9,sICAM-1,TNF-α,and IL-1βin the observation group were(430.4±30.7)pg/mL,(20.5±7.6)μmol/L,(160.4±46.3)μg/L,(480.6±70.6)μg/L,(4.3±0.6)μg/L,(4.0±2.4)μg/L,respectively,which were significantly higher than corresponding(56.8±8.7)pg/mL,(13.4±5.3)μmol/L,(86.9±15.5)μg/L,(340.7±64.3)μg/L,(2.5±0.1)μg/L,(2.6±0.1)μg/L in the control group(all P<0.05);the serum inflammatory factors like NT-proBNP,Hcy,MMP-9,sICAM-1,TNF-αand IL-1βin the large area group were(544.4±60.7)pg/mL,(24.5±8.6)μmol/L,(240.4±43.3)μg/L,(593.6±70.6)μg/L,(4.7±0.6)μg/L,(4.6±0.4)μg/L,respectively,which were significantly higher than corresponding(356.8±48.7)pg/mL,(16.5±4.9)μmol/L,(123.9±35.5)μg/L,(440.7±67.3)μg/L,(3.5±0.2)μg/L,(3.1±0.1)μg/L in the middle and small area group(all P<0.05).The serum inflammatory factors were positively correlated with the infarction area and cranial nerve defects(r=0.54,0.33,P<0.01).Conclusion The serum inflammatory factors are positively correlated with the infarction area and cranial nerve defects in ACI patients.