血清白细胞介素-1β、肿瘤坏死因子-α与脑梗死患者预后的关系研究  

Relationship between IL-1β,TNF-αand prognosis of patients with cerebral infarction

作　　者：吴延华 郭江涛 赵广珍 李艳 宋清扬 Wu Yanhua;Guo Jiangtao;Zhao Guangzhen(Department of Neurology,Beijing Longfu Hospital,Beijing 100010,China)

机构地区：[1]北京市隆福医院神经内科,100010 [2]北京市隆福医院急诊科,100010 [3]北京市隆福医院老年科,100010

出　　处：《中华保健医学杂志》2024年第1期45-48,共4页Chinese Journal of Health Care and Medicine

基　　金：北京市中医药科技发展资金项目(QYSF-2020-06)。

摘　　要：目的探究血清白细胞介素-1β(interleukin-1,IL-1β)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)对于脑梗死患者预后的关系。方法选取2022年1月~12月于北京市隆福医院神经内科就诊的经影像学等临床检查确诊的急性脑梗死患者136例为观察组,以及同期体检的健康志愿者136例为健康对照组。统计两组对象的一般资料,并比较两组IL-1β、TNF-α水平及美国国立卫生研究所卒中量表(NIHSS)评分差异。采用多因素logistic回归模型分析脑梗死患者预后与IL-1β、TNF-α的关系。结果与健康对照组相比,观察组患者IL-1β、TNF-α水平明显上升,而观察组患者进入恢复期后,IL-1β、TNF-α水平回落[(1.35±0.22)pg ml、(4.03±0.43)pg ml、(3.06±0.43)pg ml;(1.18±0.14)pg ml、(4.32±0.34)pg ml、(3.31±0.38)pg ml],与急性期比较差异亦有统计学意义(P<0.05)。NIHSS评分与患者脑梗死程度与IL-1β、TNF-α水平呈负相关(P<0.05)。logistic多因素回归分析显示,IL-1β、TNF-α水平升高是影响急性脑梗死患者预后的独立危险因素(P<0.05)。ROC结果显示,IL-1β、TNF-α升高对急性脑梗死患者预后诊断效果曲线下面积(AUC)分别为0.758、0.768,对应灵敏度分别为82.43%、65.13%,特异性分别为68.59%、94.11%;二者联合诊断的AUC为0.893,灵敏度和特异度分别为83.72%和94.13%。结论急性脑梗死患者血清IL-1β、TNF-α水平升高,二者对于脑梗死患者预后有一定的关系及诊断价值,但二者联合的预测诊断效能更好,可在临床应用。Objective To explore the relationship between IL-1βand TNF-αlevels and the prognosis of patients with cerebral infarction.Methods A total of 136 patients with acute cerebral infarction diagnosed by clinical examination including imaging from January 2022 to December 2022 in our neurology department were selected as the study group,and 136 healthy volunteers from our hospital′s health examination were selected as the control group.General data of both groups were collected,and the levels of IL-1βand TNF-αwere compared along with NIHSS scores.Multifactorial logistic regression analysis was performed to analyze the relationship between the prognosis of cerebral infarction patients and IL-1βand TNF-α.Results Compared with the control group,the levels of IL-1βand TNF-αwere significantly elevated in the study group(P<0.05),and there were significant differences in the levels of IL-1βand TNF-αbetween the recovery period and the acute period in the study group(P<0.05).NIHSS scores were negatively correlated with the severity of cerebral infarction and the levels of IL-1βand TNF-α(P<0.05).Multifactorial logistic regression analysis showed that elevated IL-1βand TNF-αlevels were independent risk factors affecting the prognosis of acute cerebral infarction patients(P<0.05).The ROC result showed that the areas under the curve(AUC)of IL-1βand TNF-αelevation in predicting the prognosis of acute cerebral infarction patients were 0.758 and 0.768,with corresponding sensitivities of 82.43%and 65.13%,and specificities of 68.59%and 94.11%,respectively.The combined diagnostic AUC was 0.893,with sensitivities and specificities of 83.72%and 94.13%,respectively.Conclusion Serum IL-1βand TNF-αlevels are elevated in patients with acute cerebral infarction,and both have certain relationships and diagnostic value for the prognosis of cerebral infarction patients.Furthermore the combined predictive diagnostic efficacy of both is better and can be widely used in clinical practice.

关 键 词：白细胞介素-1Β 肿瘤坏死因子-Α 美国国立卫生研究所卒中量表评分 急性期脑梗死 预后 

分 类 号：R743[医药卫生—神经病学与精神病学]