脑梗死合并脑动脉狭窄患者血清炎症细胞因子、Hcy水平与IMT值的变化及相关性研究  

The changes and correlation among serum inflammatory cytokines,Hcy and IMT in patients with cerebral infarction complicated with cerebral arterial stenosis

作　　者：孔庆飞[1] 徐媛 班立芳 班勇 周文明 冯少阳 KONG Qingfei;XU Yuan;BAN Lifang;BAN Yong;ZHOU Wenming;FENG Shaoyang(Department of Clinical Laboratory,the Sixth People′s Hospital of Zhengzhou,Zhengzhou,Henan 450015,China;Department of Neurology,the Ninth People′s Hospital of Zhengzhou,Zhengzhou,Henan 450053,China;Department of Neurology,the Sixth People′s Hospital of Zhengzhou,Zhengzhou,Henan 450015,China;Department of Ultrasound,the Sixth People′s Hospital of Zhengzhou,Zhengzhou,Henan 450015,China)

机构地区：[1]河南省郑州市第六人民医院检验科,河南郑州450015 [2]河南省郑州市第九人民医院神经内科,河南郑州450053 [3]河南省郑州市第六人民医院神经内科,河南郑州450015 [4]河南省郑州市第六人民医院超声科,河南郑州450015

出　　处：《检验医学与临床》2020年第21期3094-3097,共4页Laboratory Medicine and Clinic

基　　金：郑州市科技攻关计划项目(20150109)。

摘　　要：目的探讨脑梗死合并脑动脉狭窄患者血清炎症细胞因子、同型半胱氨酸(Hcy)水平与颈动脉内膜中层厚度(IMT)值的变化及相关性。方法选取2015年7月至2018年10月郑州市第六人民医院收治的94例脑梗死合并脑动脉狭窄患者作为研究对象,根据脑动脉狭窄程度分为Ⅰ级(25例)、Ⅱ级(40例)和Ⅲ级(29例)。静脉采血检测血清肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6、IL-8、C反应蛋白(CRP)等炎症细胞因子和Hcy水平,并通过颈动脉彩超检测IMT值。根据IMT值将患者分为颈动脉内膜正常组(32例)、颈动脉内膜增厚组(46例)、颈动脉内膜斑块形成组(16例)。结果脑动脉狭窄Ⅱ级患者血清TNF-α、IL-6、IL-8、CRP、Hcy水平及IMT值均高于Ⅰ级患者,Ⅲ级患者上述指标水平均高于Ⅰ级和Ⅱ级患者,差异有统计学意义(P<0.05)。颈动脉内膜增厚组患者血清TNF-α、IL-6、IL-8、CRP和Hcy水平均高于颈动脉内膜正常组患者,颈动脉内膜斑块形成组患者上述指标水平均高于颈动脉内膜正常组和颈动脉内膜增厚组,差异有统计学意义(P<0.05)。研究对象血清CRP、TNF-α、IL-6、IL-8、Hcy水平与IMT值均呈明显正相关(r=0.484、0.370、0.394、0.519、0.441,均P<0.05)。结论血清炎症细胞因子、Hcy水平与颈动脉IMT值存在相关性,三者共同参与脑梗死合并脑动脉狭窄的发生、发展过程。Objective To investigate the changes and correlation of serum inflammatory cytokines,homocysteine(Hcy)and carotid intima-media thickness(IMT)in patients with cerebral infarction complicated complicated with cerebral artery stenosis.Methods From July 2015 to October 2018,94 patients with cerebral infarction complicated with cerebral artery stenosis in the Sixth People′s Hospital of Zhengzhou were selected as the research objects.According to the degree of cerebral artery stenosis,they were divided into gradeⅠ(25 cases),gradeⅡ(40 cases)and gradeⅢ(29 cases).The serum levels of tumor necrosis factorα(TNF-α),interleukin(IL)-6,IL-8,C-reactive protein(CRP)and Hcy were detected by venous blood sampling,and carotid artery IMT was detected by carotid artery color Doppler ultrasound.According to the IMT value of carotid artery,the patients were divided into carotid intima normal group(32 cases),carotid intima thickening group(46 cases)and carotid intima plaque formation group(16 cases).Results The serum levels of TNF-α,IL-6,IL-8,CRP,Hcy and IMT in patients with gradeⅡcerebral artery stenosis were higher than those in patients with gradeⅠ,and the levels of the above indicators in patients with gradeⅢwere higher than those in patients with gradeⅠand gradeⅡ(P<0.05).The serum levels of TNF-α,IL-6,IL-8,CRP and Hcy in the carotid intima thickening group were higher than those in the carotid intima normal group,and the levels of the above indexes in the carotid intima plaque formation group were higher than those in the carotid intima normal group the carotid intima thickening group(P<0.05).The levels of CRP,TNF-α,IL-6,IL-8 and Hcy were positively correlated with IMT(r=0.484,0.370,0.394,0.519,0.441,all P<0.05).Conclusion The levels of inflammatory cytokines and Hcy were correlated with carotid IMT,which were involved in the occurrence and development of cerebral infarction complicated with cerebral artery stenosis.

关 键 词：脑梗死 脑动脉狭窄 颈动脉内膜中层厚度 炎症细胞因子 同型半胱氨酸 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R544.1[医药卫生—临床医学]