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[脑梗死患者血清白细胞介素-6、可溶性细胞间黏附分子-1的变化及临床意义]

[Changes and clinical significance of serum IL-6, sICAM-1 in patients with cerebral infarcts].

作者信息

Liu Zun-Jing, Yang Qi-Dong, Liu Yun-Hai, Huang Xiao-Song, Zhang Ning

机构信息

Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008 , China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2004 Jun;29(3):326-9.

PMID:16136971
Abstract

OBJECTIVE

To analyze the changes and clinical significance of IL-6 and sICAM-1, and to explore their pathologic mechanism in the brain ischemia.

METHODS

Thirty-two patients at Xiangya Hospital who experienced infarcts that occurred within the first 3 days were consecutively selected into the study, and 30 healthy subjects were selected as controls. The serum level of IL-6 and sICAM-1 was measured by radioimmunoassy and enzyme linked immunosorbent assay. Eleven out of the 32 patients that experienced stroke within 24 hours were observed on the 1st, 3rd, and 6th day. The subsequent volume of brain lesion as a consequence of stroke was measured by CT within 48 - 72 hours after the onset.

RESULTS

Both the serum levels of IL-6 and sICAM-1 were significantly higher in patients within the first 3 days after the onset than those of the controls [(352. 1 +/- 31.7) pg/ml vs. (135.4 +/- 18.3) pg/ml, and (363.6 +/- 48.4) ng/ml vs. (227.2 +/- 30.1) ng/ml, P < 0.01]. The levels of IL-6 at the 6th day [(308.3 +/- 26.8) pg/ml] was significantly lower than that both on the 1st day [(364.5 +/- 29.7) pg/ml] and on the 3rd day [(345 +/- 28.9) pg/ml] (P <0.01). There was no significant difference between the 1st day and the 3rd day (P > 0.05). Statistical significance existed in each two concentrations of sICAM-1 on the 1st day [(383.9 +/- 56.1) ng/ml], the 3rd day [(354.6 +/- 40.8) ng/ml], and the 6th day [(316.7 +/- 32.3) ng/ml] (P < 0.05). Both the levels of IL-6 and sICAM-1 were higher in patients within the 6th day after the onset than those of sICAM-1 on the controls (P < 0.01). There was a positive correlation between both the levels of IL-6 and sICAM-1 at the first 3 days after the onset and the infarct volume (r = 0. 368, P < 0. 05 and r = 0. 594, P < 0. 01) , and the sICAM-1 positively correlated with IL-6 (r = 0. 453, P < 0. 05).

CONCLUSION

The serum levels of IL-6 and sICAM-1 were upregulated, which might play a role in inflammatory lesion, and the upregulation of sICAM-1 may be related to the IL-6. The levels of IL-6 and sICAM-1 may reflect both the degree of pathologic lesion after the brain ischemia and the infarct volume.

摘要

目的

分析白细胞介素-6(IL-6)和可溶性细胞间黏附分子-1(sICAM-1)的变化及其临床意义,探讨其在脑缺血中的病理机制。

方法

连续选取32例发病3天内于湘雅医院就诊的梗死患者作为研究对象,并选取30例健康受试者作为对照。采用放射免疫分析和酶联免疫吸附测定法检测血清IL-6和sICAM-1水平。对32例发病24小时内的患者中的11例在第1天、第3天和第6天进行观察。在发病后48 - 72小时内通过CT测量卒中导致的后续脑损伤体积。

结果

发病后前3天患者血清IL-6和sICAM-1水平均显著高于对照组[(352.1±31.7)pg/ml对(135.4±18.3)pg/ml,以及(363.6±48.4)ng/ml对(227.2±30.1)ng/ml,P<0.01]。第6天IL-6水平[(308.3±26.8)pg/ml]显著低于第1天[(364.5±29.7)pg/ml]和第3天[(345±28.9)pg/ml](P<0.01)。第1天和第3天之间无显著差异(P>0.05)。第1天[(383.9±56.1)ng/ml]、第3天[(354.6±40.8)ng/ml]和第6天[(316.7±32.3)ng/ml]的sICAM-1各两个浓度之间存在统计学差异(P<0.05)。发病后6天内患者的IL-6和sICAM-1水平均高于对照组的sICAM-1水平(P<0.01)。发病后前3天IL-6和sICAM-1水平与梗死体积均呈正相关(r = 0.368,P<0.05和r = 0.594,P<0.01),且sICAM-1与IL-6呈正相关(r = 0.453,P<0.05)。

结论

血清IL-6和sICAM-1水平上调,可能在炎症损伤中起作用,且sICAM-1的上调可能与IL-6有关。IL-6和sICAM-1水平可能反映脑缺血后病理损伤程度及梗死体积。

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