血清同型半胱氨酸及白细胞介素-6和超敏C-反应蛋白在急性脑卒中病程中的变化及其意义  

Change and clinical significance of serum homocysteine acid, interleukin-6 and high sensitive C-reactive protein during acute stroke.

作　　者：白旭东 岳蕴华 李伟孜 王红 陈丽 

机构地区：[1]新疆维吾尔自治区乌鲁木齐市友谊医院干部科,830049 [2]新疆维吾尔自治区乌鲁木齐市友谊医院神经内科,830049 [3]新疆维吾尔自治区乌鲁木齐市友谊医院临床检验科,830049

出　　处：《中国综合临床》2010年第10期1014-1017,共4页Clinical Medicine of China

基　　金：新疆维吾尔自治区卫生厅青年科技人才专项科研项目（2009Y05）

摘　　要：目的观察血清同型半胱氨酸（Hey）及白细胞介素-6（IL-6）、超敏C-反应蛋白（hs—CRP）在不同病情程度急性脑卒中（AS）患者中的差异。方法选择AS患者126例。按临床神经功能缺损程度评分标准进行病情程度及预后分组。分别测定发病后第3、14、28天血清Hcy、IL-6、hs-CRP浓度。选择同期健康体检者108名作为对照组。结果①AS组血清Hcy、IL-6和hs—CRP水平明显高于健康对照组[（58．24±9．86）、（17．12±4．23）μmoL／L，（59．64±13．82）、（18．46±4．62）ng／L，（19．78±6．12）、（2．28±0．82）mg／L，t值分别为2．623、2．761、3．746，P均〈0．01]；②发病第3天重、中、轻型AS组血清Hcy、IL-6、hs—CRP水平均高于健康对照组（P均〈0．01），且重型组、中型组高于轻型组（P均〈0．01）；发病第14天重型组与中型组高于轻型组及健康对照组（P均〈0．01）；发病第28天重型组高于中、轻型组及健康对照组（P均〈0．01）。③发病第28天基本治愈组与显著进步组较无变化组的血清Hcy、IL-6、hs—CRP水平明显降低[（16．12±4．74）、（18．42±5．02）、（48．69±7．89）μmol／L，（19．52±5．67）、（20．74±6．13）、（51．26±11．66）ng／L，（3．21±1．36）、（3．24±2．51）、（8．86±1．32）mg／L，P均〈0．01]。结论血清Hcy、IL-6、hs—CRP是临床评价AS严重程度和预后的重要生物学指标。Objective To observe the changes of serum homocysteine acid （Hcy） ,interleukin-6 （IL-6） and high sensitive C-reactive protein （hs-CRP） and elucidate the clinical significance in patients with acute stroke. Methods A total of 126 acute stroke patients were enrolled in the investigation. Based on the MESS,patients were divided into different groups according the severity and prognosis, and 108 physically healthy subjects were selected as controls. The concentration of serum Hcy, IL-6, and hs-CRP were determined in all cases after being attacked at day 3, day 14 and day 28 respectively. Results （1）The levels of Hcy, IL-6, hs-CRP in patients with acute stroke were significantly higher than controls （ （58.24 ±9.86） μmol/L vs. （ 17.12 ±4.23） μmol/L, （59.64 ±13.82） ng/L vs. （ 18.46±4.62） ng/L, （ 19.78 ± 6.12） mg/L vs. （2.28 ±0.82） mg/L, all P 〈 0.01 ）. （2）The levels of Hcy, IL-6, hs-CRP in patients with mild, moderate and severe acute stroke were significantly higher than controls （ P 〈 0.01 ） at 3 day after the onset ; and the Hcy, IL-6, hs-CRP were also significantly lower in mild cases with acute stroke compared with moderate and severe cases （P 〈 0.01 ）. At day 14, the moderate and severe patients had significantly higher levels of Hcy ,IL-6, hs-CRP than mild cases and controls （P 〈 0.01 ）. At day 28 the severe patients had significantly higher levels of Hcy, IL-6, hs-CRP than mild and moderate cases and controls （P 〈 0.01 ） ; （3）At day 28, the levels of Hcy, IL-6, hs-CRP in basically recovered and remarkably improved cases were significantly lower than unrecovered cases [ （ 16.12±4.74 ） μmol/L, （ 18.42 ±5.02 ） μmol/L vs. （ 48.69 ±7.89 ） μmol/L; （19. 52± 5. 67 ） ng/L, （20. 74 ±6. 13） ng/L vs. （51.26±11.66） ng/L, （3. 21±1. 36） mg/L, （ 3.24±2.51 ） mg/L vs. （ 8.86±1.32 ） mg/L respectively, all P 〈 0.01 ]. Conclusions The levels of serum Hcy, IL-6, hs-CRP are significant biomarkers to e

关 键 词：急性脑卒中 同型半胱氨酸 白细胞介素-6 超敏C-反应蛋白 

分 类 号：R743.3[医药卫生—神经病学与精神病学]