缺血性卒中后血浆超敏C-反应蛋白和白介素-6的早期动态变化与临床表现的关系探讨

摘要

目的 观察急性缺血性卒中患者发病后早期血浆超敏c反应蛋白(high sensitive C-reactive protein,hs-CRP)及白介素-6 (interleukin-6,IL-6)水平的动态变化规律,探讨其与卒中患者临床表现及预后的关系.方法:连续入选急性缺血性卒中患者47例,正常对照组40例,比较卒中组发病后系列时间点血浆hs-CRP和IL-6水平与正常对照组之间的差异,分析其动态变化规律;按照基线美国国立卫生研究院卒中量表(national institutes of health stroke scale,NIHSS)评分将患者分为轻型组(n=15)和重型组(n=32),比较两组血浆hs-CRP和IL-6水平;并比较不同临床预后患者血浆hs-CRP和IL-6水平的差异.结果:卒中组发病3h时血桨hs-CRP较对照组差异无统计学意义,6h、12h、24h、48h、3d及7d血浆hs-CRP较对照组明显升高(均P<0.01).卒中组各时间点血浆IL-6水平均高于正常对照组(均PG0.01).重型组血浆hs-CRP水平在12h、24h、48h、3d及7d时水平均高于轻型组(P=0.046,0.012,0.030,0.007,0.041);重型组血浆IL-6水平在12h、24h、48h、3d及7d时水平均高于轻型组(P=0.002,0.001,0.006,0.026,0.043).不同预后组之间血浆hs-CRP和IL-6水平差异不明显.结论:急性缺血性卒中患者血浆hs-CRP和IL-6水平升高,且与临床严重程度有关.%Objective To investigate the early time course of plasma high sensitive C-reactive protein (hsCRP) and interleukin-6 (IL-6) level after acute ischemic stroke and the relationship with clinical characters and outcome.Methods Serial enrollment of acute ischemic stroke patients (n=47) and healthy controls (n=40).We compared the serial measurements of plasma hs-CRP and IL-6 level of acute ischemic stroke patients with that of healthy controls, and analyzed their dynamic variation rules. Patients were divided into mild stroke (n=15) and severe stroke (n=32) group according to national institutes of health stroke scale (NIHSS). We compared the plasma level of hs-CRP and IL-6 0f the two groups,and also that of the patients with good and poor outcome.Results There was no difference of plasma hs-CRP at 3h between stroke patients and healthy controls, but was significantly higher in stroke patients at 6h (P=0.01), 12h (P=0.01), 24h (P＜0.01),48h (P＜0.01), 3d (P＜0.01) and 7d (P＜0.01) than controls. Plasma IL-6 0f stroke patients at each time points was significantly higher than that of the controls (P＜0.01). Hs-CRP level of severe stroke patients was significantly higher than mild ones at 12h, 24h, 48h, 3d and 7d (P=0.046, 0.012,0.030, 0.007 and 0.041, respectively). The same was also true for IL-6 at those time points (P=0.002,0.001, 0.006, 0.026 and 0.043, respectively). There was no difference of plasma hs-CRP and IL-6 level between patients with good and poor outcome.Conclusion Plasma hs-CRP and IL-6 levels elevated after acute ischemic stroke, and correlated with clinical severity.