血清炎症细胞因子、同型半胱氨酸水平与颈动脉内膜中层厚度值对脑梗死合并脑动脉狭窄的影响

Effects of serum inflammatory cytokines,homocysteine levels,and carotid artery intima-media thickness on cerebral infarction complicated with cerebral artery stenosis

目的探讨同型半胱氨酸(Hcy)水平、血清炎症细胞因子与颈动脉内膜中层厚度(IMT)值对脑梗死合并脑动脉狭窄的影响。方法选取西安高新医院2019年1月至2020年12月收治的186例脑梗死合并脑动脉狭窄患者作为研究对象,根据患者颈内动脉狭窄率将患者分为Ⅰ型49例、Ⅱ型82例、Ⅲ型55例,根据颈内动脉彩超中IMT值将患者分为颈动脉内膜正常组(IMT值<1 mm)42例、增厚组(1 mm≤IMT值<1.5 mm)109例和斑块形成组(IMT值>1.5 mm)35例,测定所有患者Hcy水平、炎症细胞因子,比较脑梗死合并脑动脉狭窄患者不同亚分组间的Hcy、炎症细胞因子水平,并采用Pearson系数分析Hcy、炎症细胞因子与IMT值之间的相关性。结果随着颈内动脉狭窄程度的增加,患者的肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素(IL-8)、C反应蛋白(CRP)、Hcy水平均随之升高,差异均有统计学意义(P<0.05);颈动脉内膜正常组、增厚组和斑块形成组患者的TNF-α、IL-6、IL-8、CRP和Hcy水平依次升高,差异均有统计学意义(P<0.05);经Pearson系数分析结果显示,炎症细胞因子与IMT值呈正相关(P<0.05),Hcy与IMT值也呈正相关(P<0.05)。结论炎症细胞因子、Hcy和IMT均参与脑梗死伴脑动脉狭窄患者病情发生和发展的过程,三者之间有着密切的联系,并且前两者与IMT值之间均呈正相关。

Objective To investigate the effects of homocysteine(Hcy),serum inflammatory cytokines,and carotid intimamedia thickness(IMT)on cerebral infarction complicated with cerebral artery stenosis.Methods A total of 186 patients with cerebral infarction complicated with cerebral artery stenosis admitted to Xi'an Gaoxin Hospital from January 2019 to December 2020 were selected as the study objects.According to the internal carotid artery stenosis rate,the patients were divided into typeⅠof 49 cases,typeⅡof 82 cases,and typeⅢof 55 cases.According to IMT value in internal carotid artery color ultrasound,the patients were divided into normal carotid intima group(IMT value<1 mm,42 cases),thickening group(1 mm≤IMT value<1.5 mm,109 cases),and plaque formation group(IMT value>1.5 mm,39 cases).The Hcy level and inflammatory cytokines were measured in all patients,and the levels of Hcy and inflammatory cytokines in different subgroups of patients with cerebral infarction complicated with cerebral artery stenosis were compared.Pearson coefficient was used to analyze the correlation between Hcy,inflammatory cytokines and IMT values.Results With the increase of the degree of internal carotid artery stenosis,the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8),Creactive protein(CRP),and Hcy were increased,and the difference was statistically significant(P<0.05).The levels of TNF-α,IL-6,IL-8,CRP,and Hcy in normal carotid intima group,thickening group,and plaque formation group were increased successively,and the differences were statistically significant(P<0.05).Pearson coefficient analysis showed that inflammatory cytokines were positively correlated with IMT values(P<0.05),and Hcy was also positively correlated with IMT values(P<0.05).Conclusion Inflammatory cytokines,Hcy,and IMT are all involved in the occurrence and development of cerebral infarction patients with cerebral artery stenosis.There is a close relationship between them,and inflammatory cytokines,Hcy are positively correlated with IMT.