血浆抗凝血酶和炎症meijiangneirong平分析

Plasma levels of antithrombin and inflammatory factors in patients with cerebral infarction

目的探讨血浆抗凝血酶(AT-Ⅲ)和炎症因子(TNF-α、IL-6)在脑梗死患者中的变化。方法收集110例脑梗死患者为研究组,110名健康体检者为对照组。发色底物法测定血浆AT-Ⅲ活性; EIisa试剂盒检测血浆免疫复合物水平; Elisa法测定血浆TNF-α、IL-6水平。分离外周血单核细胞,流式细胞术检测细胞表型;使用免疫复合物刺激单核细胞,检测TNF-α、IL-6水平变化。结果研究组血浆AT-Ⅲ活性低于对照组,差异有统计学意义(P <0. 05)。脑梗死患者血浆AT-Ⅲ活性与收缩压、舒张压、空腹血糖、TC、TG、LDL-C、同型半胱氨酸、神经功能损伤积分呈负相关,与HDL-C呈正相关。研究组血浆免疫复合物水平高于对照组,差异有统计学意义(P <0. 01);研究组TNF、IL-6水平高于对照组,差异有统计学意义(P <0. 01)。CD14+CD16+、CD14+CD32+单核细胞比例在两组间差异无统计学意义(P> 0. 05);研究组CD14+CD64+单核细胞比例高于对照组,差异有统计学意义(P <0. 05)。外周血单核细胞TNF-α、IL-6分泌量随着Ig-IC复合物浓度的增加而提升。结论 AT-Ⅲ在脑梗死患者血浆中活性下降,且与脑梗死危险因素相关;脑梗死患者体内免疫复合物可能通过结合CD14+CD64+单核细胞,分泌大量促炎细胞因子,改变AT-Ⅲ活性。

Objective To investigate the changes of plasma antithrombin(AT-Ⅲ)and inflammatory factors(TNF-alpha and IL-6)in patients with cerebral infarction.Methods A total of 110 patients with cerebral infarction were selected as the study group and 110 healthy subjects as control group.The activity of plasma AT-Ⅲwas measured by chromogenic substrate method,the level of plasma immune complexes was detected by EIA kit,and the levels of TNF-and IL-6 in plasma were measured by Elisa.Peripheral blood mononuclear cells were isolated,cell phenotype was detected by flow cytometry,and the levels of TNF-and IL-6 were detected by immunomodulator stimulation.Results The plasma AT-Ⅲactivity in the study group was significantly lower than that in the control group(P<0.05).The plasma AT-Ⅲactivity in patients with cerebral infarction was negatively correlated with the score of systolic pressure,diastolic pressure,fasting blood glucose,TC,TG,LDL-C,homocysteine and nerve function injury scores,and was positively related to HDL-C.The level of plasma immune complex in the study group was significantly higher than that of the control group,the difference was statistically significant(P<0.01),and the level of TNF and IL-6 in the study group was significantly higher than that of the control group,the difference was statistically significant(P<0.01).There was no significant difference in the proportion of CD14+CD16+and CD14+CD32+mononuclear cells between the two groups(P>0.05),and the proportion of CD14+CD64+mononuclear cells in the study group was significantly higher than that of the control group,the difference was statistically significant(P<0.05).The secretion of TNF-and IL-6 in peripheral blood mononuclear cells increased significantly with the increase of Ig-IC complex concentration.Conclusion The plasma activity of AT-Ⅲin patients with cerebral infarction is significantly decreased and related to the risk factors of cerebral infarction.The immune complex in cerebral infarction patients may produce a large number of proinflammatory cytokines and change the activity of AT-Ⅲby combining with CD14+CD64+mononuclear cells.