急性脑梗死与血清炎性因子的相关性研究

摘要

Objective:To investigate the changes of serum inflammatory cytokines in patients with acute cerebral infarction (ACI) and its clinical significance by detecting the serum levels of homocysteine (Hcy),cystatin C (Cys C),high-sensitivity C-reactive protein (hs-CRP) . Methods:A total of 82 ACI patients (ACI group) and 50 healthy persons (control group) were selected,the serum Hcy,Cys C,hs-CRP levels of all subjects were determined,the relationship between inflammatory cytokines and USA National Institutes of Health Stroke Scale (NIHSS) was analyzed. Finally,the roles of inflammatory cytokines in diagnosis of ACI were evaluated. Results:The levels of Hcy,Cys-C and hs-CRP in ACI group were significantly higher than those in control group (P<0.01) . The serum levels of these factors had significant difference among different neurological deficiency groups (P<0.05), and had a positive correlation with NIHSS score (r=0.396, 0.445, 0.391, P<0.01), hs-CRP had the highest sensitivity (72.0%) and specificity (82.0%) for diagnosis of ACI. Conclusions:The hs-CRP, Hcy and Cys C play important roles in the onset and development of ACI and can reflect the severity of ACI. Among them,Hcy is the important dangerous factor of ACI,the level of Cys C reflectes the degree of the vascular inflammatory injury,and hs-CRP can be used as an index to diagnose and evaluate the severity of ACI.%目的：观察急性脑梗死（ACI）患者血清同型半胱氨酸（Hcy）、胱抑素C （Cys C）、超敏C反应蛋白（hs-CRP）水平的变化，探讨三种炎性因子与ACI关系及临床意义。方法：对比82例ACI和50例对照者的血清Hcy、Cys C、hs-CRP水平差异，分析炎性因子与卒中量表（NIHSS）评分相关性，判断三种炎性因子在ACI诊断中的作用。结果：研究组血清Hcy、Cys C、hs-CRP水平明显高于对照组（P均<0.01）。不同神经功能缺损程度组间炎性因子水平两两比较，差异均有统计学意义（P均<0.05），Hcy、Cys C、hs-CRP水平与NIHSS评分均呈正相关（r=0.396、0.445和0.391，P均<0.01），hs-CRP对ACI的诊断具有最高的敏感度（72.0%）和特异度（82.0%）。结论：血清hs-CRP、Hcy和Cys C在ACI的发生、发展过程中均起到重要作用，且均可反映ACI病变轻重程度。其中Hcy为ACI发病的重要危险因素，Cys C水平可反映血管炎性损伤程度，hs-CRP可作为ACI的诊断及病情严重程度的判断因子。