老年脑梗死患者血清可溶性CD40配体和白细胞介素18的变化及意义

摘要

目的 探讨老年脑梗死患者血清可溶性CD40配体(sCD40L)、白细胞介素18(IL-18)及高敏C反应蛋白(hs-CRP)水平的变化及意义.方法 选择急性脑梗死患者80例(脑梗死组),根据年龄分为老年脑梗死患者42例,非老年脑梗死患者38例;根据梗死面积分为腔隙性脑梗死患者38例,非腔隙性脑梗死患者42例;根据神经功能缺损评分分为重型患者16例,中型患者30例,轻型患者34例.同期健康体检者28例(对照组).采用ELISA法和胶乳凝集法检测血清sCD40L、IL-18及hs-CRP水平.结果 与对照组比较,脑梗死组老年脑梗死和非老年脑梗死患者血清sCD40L、IL-18及hs-CRP水平明显升高,腔隙性脑梗死和非腔隙性脑梗死患者血清sCD40L、IL-18及hs-CRP水平明显升高,神经功能缺损中型和重型患者sCD40L、IL-18及hs-CRP水平明显升高,差异有统计学意义(P<0.05,P<0.01).血清sCD40L与IL-18呈正相关(r=0.7645,P<0.01).结论 脑梗死患者急性期血清sCD40L、IL-18、hs-CRP水平明显升高,且随年龄、梗死体积和神经功能缺损程度增加而加重,sCD40L可能上调IL-18表达,并参与脑梗死炎性反应过程.%Objective To study the serum levels of soluble CD40 ligand (sCD40L),IL-18 and hs-CRP in elderly patients with acute cerebral infarction (ACI) and their significance . Methods Eighty ACI patients were divided into elderly ACI group (n=42) and non-elderly ACI group (n= 38) according to their age lacunar ACI group(n=38) and non-lacunar ACI group(n=42) according to their infaction size ,and servere ACI group (n= 16 ),moderate ACI group (n= 30) and mild ACI group (n= 34) according to their nerve function deficiency score .Twenty healthy subjects served as a control group .Their serum levels of sCD40L,IL-18 and hs-CRP were measured by ELISA and latex agglutination test ,respectively .Results The serum levels of sCD40L ,IL-18 and hs-CRP were significantly higher in elderly ACI group and non-elderly ACI group Jacunar ACI group and non-lacunar ACI group, and servere ACI group , moderate ACI group and mild ACI group than in control group ( P<0 .05 ,P<0 .01) .The serum sCD40L level was positively related with the serum IL-18 level(r=0 .7645 , P<0 .01) .Conclusion The serum levels of sCD40L ,IL-18 and hs-CRP increase with the age ,infaction size and severity of nerve function deficiency in ACI patients .The sCD40L-upregulated expression of IL-18 may be involved in the inflammatory reaction in ACI patients .