Licata Giuseppe, Tuttolomondo Antonino, Di Raimondo Domenico, Corrao Salvatore, Di Sciacca Riccardo, Pinto Antonio
Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Pizza delle Cliniche n.2, 90127 Palermo, Italy.
Thromb Haemost. 2009 May;101(5):929-37.
Few studies have examined the relationship between inflammatory biomarker blood levels, cardioembolic stroke subtype and neurological deficit. So the aim of our study is to evaluate plasma levels of immuno-inflammatory variables in patients with cardio-embolic acute ischaemic stroke compared to other diagnostic subtypes and to evaluate the relationship between immuno-inflammatory variables, acute neurological deficit and brain infarct volume. One hundred twenty patients with acute ischaemic stroke and 123 controls without a diagnosis of acute ischaemic stroke were evaluated. The type of acute ischaemic stroke was classified according to the TOAST classification. We evaluated plasma levels of IL-1beta, TNF-alpha, IL-6 and IL-10, E-selectin, P-selectin, sICAM-1,sVCAM-1, vWF, TPA and PAI-1. Patients with ischaemic stroke classified as cardio-embolic (CEI) showed, compared to other subtypes, significantly higher median plasma levels of TNF-alpha , IL-6 and IL-1beta. Furthermore stroke patients classified as lacunar showed, compared to other subtypes, significantly lower median plasma levels of TNF-alpha, IL-6 and IL-1beta. Multiple linear regression showed a significant association between the Scandinavian Stroke Scale (SSS) score at admission and diagnostic subtype, infarct volume of cardio-embolic strokes and some inflammatory variables. Our findings confirm that cardio-embolic strokes have a worse clinical presentation and produce larger and more disabling strokes than other ischaemic stroke subtypes reporting a possible explanation of higher immuno-inflammatory activation of the acute phase.
很少有研究探讨炎症生物标志物血液水平、心源性栓塞性卒中亚型与神经功能缺损之间的关系。因此，我们研究的目的是评估心源性栓塞性急性缺血性卒中患者与其他诊断亚型相比的免疫炎症变量血浆水平，并评估免疫炎症变量、急性神经功能缺损和脑梗死体积之间的关系。对120例急性缺血性卒中患者和123例未诊断为急性缺血性卒中的对照者进行了评估。急性缺血性卒中的类型根据TOAST分类法进行分类。我们评估了血浆中IL-1β、TNF-α、IL-6和IL-10、E-选择素、P-选择素、sICAM-1、sVCAM-1、vWF、TPA和PAI-1的水平。与其他亚型相比，归类为心源性栓塞性（CEI）的缺血性卒中患者的TNF-α、IL-6和IL-1β的血浆中位数水平显著更高。此外，与其他亚型相比，归类为腔隙性的卒中患者的TNF-α、IL-6和IL-1β的血浆中位数水平显著更低。多元线性回归显示入院时斯堪的纳维亚卒中量表（SSS）评分与诊断亚型、心源性栓塞性卒中的梗死体积和一些炎症变量之间存在显著关联。我们的研究结果证实，与其他缺血性卒中亚型相比，心源性栓塞性卒中具有更差的临床表现，会导致更大且更具致残性的卒中，这可能解释了急性期免疫炎症激活程度更高的原因。
