进展性缺血性脑卒中患者细胞因子及黏附分子的研究  

The Study of Cytokines and Soluble Adhesion Molecule in Patients with Progressing Ischemic Stroke

作　　者：易兴阳[1] 潘继豹[1] 池丽芬[1] 陈存木[1] 袁光固[1] 

机构地区：[1]温州医学院附属第三医院神经内科,浙江瑞安325200

出　　处：《中国神经免疫学和神经病学杂志》2006年第3期169-172,共4页Chinese Journal of Neuroimmunology and Neurology

摘　　要：目的探讨白细胞介素-1(IL-1)I、L-6、肿瘤坏死因子(TNF)、可溶性细胞间黏附分子-1(sICAM-1)和血管细胞黏附分子-1(sVCAM-1)在进展性缺血性脑卒中发病中的作用。方法收集108例首次发病且于起病24 h内入院的脑梗死患者作为研究对象,检测其外周血IL-1I、L-6、TNF、sVCAM-1、sICAM-1水平。进展性缺血性脑卒中的诊断根据神经功能缺损(SSS)评分判断。结果108例脑梗死患者中有29例(26.9%)于7 d内发展为进展性脑卒中,其入院时外周血IL-1I、L-6、TNFs、VCAM-1s、ICAM-1水平明显高于无进展的脑梗死患者,且皮层梗死患者外周血IL-1I、L-6、TNF、sVCAM-1、sICAM-1水平高于皮层下梗死患者(P<0.01)。经Logistic回归分析显示,IL-1I、L-6、TNF、sVCAM-1s、ICAM-1是进展性缺血性脑卒中的独立危险因素,且其外周血浓度与体温、血糖、纤维蛋白原浓度以及梗死灶大小呈正相关。结论细胞因子及黏附分子不仅参与脑梗死后急性期反应,而且其外周血水平增高与进展性缺血性脑卒中密切相关,可能在进展性缺血性脑卒中的发病过程中具有重要作用。Objective To evaluate the collective role of interleukin-1 （IL-1）, interleukin-6 （IL-6）, tumor necrosis factor（TNF）, as well as soluble intercellular adhesion molecule-1（slCAM-1）, and soluble vascular cell adhesion molecule-1 （sVCAM-1） in pathogenesis of progressing ischemic stroke. Methods 108 patients admitted with first-ever cerebral infarction within 24 hours from onset were included. The progressing ischemic stroke was defined on basis of neurological function deficit scale score. The levels of IL-1, IL-6 and, TNF, and sVCAM-1, slCAM-1 in peripheral blood were measured in patients with cerebral infarction on admission. Results Of 108 patients with cerebral infarction. 29 patients （26.9 %） progressed within 7 days, The levels of IL-1, IL-6, TNF, sVCAM-1, sICAM-1 were significantly higher in patients with progressing stroke than in patients with noprogressing stroke, and in patients with cortical infarction than in patients with subcortical infarction （P〈0. 01）. The IL-1, IL-6, TNF, sVCAM-1, slCAM-1 were independent risk factor for progressing stroke with multiple logistic regression, and their levels were correlated with body temperature, glucose, fibrinogen, and infarct volume. Conclusions The increasing levels of cytokines and soluble adhesion molecules following cerebral infarction are associated with progressing ischemic stroke. They may indicate a collective response to the ischemia and reperfusion injury in progressing ischemic stroke.

关 键 词：细胞因子 脑梗死 进展性脑卒中 黏附分子 

分 类 号：R743.32[医药卫生—神经病学与精神病学]