Department of Neuromedicine, Tbilisi State Medical University, Tbilisi, Georgia.
BMC Neurol. 2011 Mar 30;11:41. doi: 10.1186/1471-2377-11-41.
Study aimed at investigation of pathogenic role and prognostic value of several selected cerebrospinal fluid acute phase factors that can reflect the severity of ischemic brain damage.
Ninety five acute ischemic stroke patients were investigated. Ischemic region visualized at the twenty fourth hour by conventional Magnetic Resonance Imaging. Stroke severity evaluated by National Institute Health Stroke Scale. One month outcome of disease was assessed by Barthel Index. Cerebrospinal fluid was taken at the sixth hour of stroke onset. CSF pro- and anti-inflammatory cytokines were studied by Enzyme Linked Immunosorbent Assay. Nitric Oxide and Lipoperoxide radical were measured by Electron Paramagnetic Resonance. CSF Nitrate levels were detected using the Griess reagent. Statistics performed by SPSS-11.0.
At the sixth hour of stroke onset, cerebrospinal fluid cytokine levels were elevated in patients against controls. Severe stroke patients had increased interleukin-6 content compared to less severe strokes (P < 0.05). Cerebrospinal fluid Electron Paramagnetic Resonance signal of nitric oxide was increased in patients against controls. Severe stroke group had an elevated Electron Paramagnetic Resonance signal of lipoperoxiradical compared to less severe stroke. Cerebrospinal fluid nitrate levels in less severe stroke patients were higher than those for severe stroke and control. Positive correlation was established between the initial interleukin-6 content and ischemic lesion size as well as with National Institute Health Stroke Scale score on the seventh day. Initial interleukin-6 and nitrate levels in cerebrospinal fluid found to be significant for functional outcome of stroke at one month.
According to present study the cerebrospinal fluid contents of interleukin-6 and nitrates seem to be the most reliable prognostic factors in acute phase of ischemic stroke.
本研究旨在探讨几种特定的脑脊液急性期因子在反映缺血性脑损伤严重程度方面的致病作用和预后价值。
对 95 例急性缺血性脑卒中患者进行研究。常规磁共振成像于发病 24 小时显示缺血部位。采用国立卫生研究院卒中量表评估卒中严重程度。采用巴氏指数评估发病 1 个月的预后。发病 6 小时时采集脑脊液。采用酶联免疫吸附法检测脑脊液前炎症和抗炎细胞因子。采用电子顺磁共振法测量一氧化氮和脂质过氧化物自由基。采用格里斯试剂检测脑脊液硝酸盐水平。采用 SPSS-11.0 进行统计学分析。
发病 6 小时时，患者脑脊液细胞因子水平较对照组升高。与轻度卒中相比，重度卒中患者白细胞介素-6 含量增加（P < 0.05）。与对照组相比，患者脑脊液中一氧化氮电子顺磁共振信号升高。与轻度卒中相比，重度卒中患者的脂质过氧化物自由基电子顺磁共振信号升高。轻度卒中患者的脑脊液硝酸盐水平高于重度卒中患者和对照组。初始白细胞介素-6 含量与缺血性病灶大小以及第 7 天国立卫生研究院卒中量表评分呈正相关。发病后 1 个月时，脑脊液中白细胞介素-6 和硝酸盐水平是影响卒中功能预后的重要因素。
根据本研究，脑脊液中白细胞介素-6 和硝酸盐含量似乎是缺血性卒中急性期最可靠的预后因素。
