缺血性卒中不同亚型患者血清CXCL12水平急性期动态观察

摘要

目的 观察缺血性卒中不同亚型患者急性期血清趋化因子配体12(CXCL-12)水平的动态变化.方法 选择2014年1月～2016年6月在延安大学附属医院老年病科治疗的141例急性缺血性卒中患者,按照TOAST分型方法分为大动脉粥样硬化性卒中(LAA)52例,小动脉闭塞性脑卒中或腔隙性脑卒中(SAO)组54例和心源性脑栓塞(CE)组35例,另外选取60例同期门诊健康体检成人设置对照.分别于入院时及发病第3,7,14天四个时间点,采用ELISA法检测卒中患者血清CXCL12水平.结果 三个亚组患者在急性期4个时间点血清CXCL-12水平均高于对照组(F=29.523,31.690,38.962,22.365,均P＜0.001),血清CXCL-12水平动态变化均表现为发病24 h内显著升高,发病第3天达到峰值,之后缓慢下降.多因素Logistic回归分析结果显示对于三个亚组,均表现为发病第7天血清CXCL-12升高与预后不良相关.结论 缺血性卒中不同亚型患者急性期血清CXCL-12均显著升高,且血清CXCL-12过高可能提示患者预后不良.%Objective To observe the dynamic change of serum CXCL-12 in patients with different subtypes of acute ischemic stroke.Methods 141 patients with acute ischemic stroke from January 2014 to June 2016 were recruited to participate in the study as stroke group.According to TOAST classification,they were divided into LAA group (52 cases),SAO group (54 cases) and CE group (35 cases).60 healthy physical examination patients in Affiliated Hospitd of Yan'an University physical examination centre in same time were selected as control group.Serum CXCL-12 of stroke patients were detected at admission,3th day,7th day and 14th day after stroke.Results Compared with the control group,the serum CXCL-12 level at four different time during acute stage were higher in three subgroups.Serum CXCL-12 in patients of three stoke subgroups was significantly increase within 24 hour after stroke.And it would peak at 3th day.Then,the level of serum CXCL-12 began to fall.Multivariate Logistics analysis showed that serum CXCL-12 level in patients with three different stroke subgroups at 7th day after stroke was the risk factor of poor prognosis.Conclusion For the patients with different subtypes of acute ischemic stroke,the serum CXCL-12 levels increased significantly.Moreover,the high level of serum CXCL-12 may correlate with poor prognosis.