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促炎血清标志物:高敏C反应蛋白、白细胞介素-6与急性缺血性卒中残疾评分之间的相关性

Correlation between proinflammatory serum markers: high sensitivity C-reactive protein, interleukin-6 with disability score in acute ischemic stroke.

作者信息

Bharosay Anuradha, Saxena Kiran, Varma Meena, Bharosay Vivek Vikram, Pandey Aparna

出版信息

Indian J Clin Biochem. 2011 Jul;26(3):279-82. doi: 10.1007/s12291-011-0135-1. Epub 2011 May 1.

Abstract

Stroke being the third leading cause of death and foremost cause of disability, if potential diagnostic utility of blood borne protein biomarkers in predicting acute stroke is established, it would be a substantial adjunct to computerized tomography and magnetic resonance imaging which have their own limitations. This study was done to correlate serum Interleukin 6, high sensitivity C reactive protein at the time of admission with neurological worsening assessed by NIHSS at the time of admission and 7 days after admission. 46 Patients admitted in neurology department SAIMS, Indore with first ever ischemic stroke within 72 h of onset were included in the study. All patients with history of stroke of more than 72 h onset, Infection & peripartum stroke were excluded from the study. Disability scoring was done by NIHSS and their serum samples assayed for hsCRP, IL6 by commercially available quantitative sandwich enzyme-linked immunoadsorbent assay kits. Serum samples of 50 control cases which included healthy volunteers and staff from SAIMS were also analyzed for hsCRP, IL6 for comparative study. A significant correlation was observed between NIHSS scoring and serum hsCRP and IL6 at the time of admission. Patients with initial high serum IL6 and hsCRP also showed significant clinical deterioration as assessed by NIHSS scoring 7 days after admission. Elevated hsCRP and IL6 within 72 h of admission strongly correlated with functional disability in study population in India and may serve as useful adjunct to CT Scan in emergency setting.

摘要

中风是第三大致死原因和首要致残原因,如果血液中蛋白质生物标志物在预测急性中风方面的潜在诊断效用得以确立,那它将成为计算机断层扫描和磁共振成像的重要辅助手段,而这两种成像技术都有其自身的局限性。本研究旨在将入院时血清白细胞介素6、高敏C反应蛋白与入院时及入院7天后通过美国国立卫生研究院卒中量表(NIHSS)评估的神经功能恶化情况进行关联分析。纳入研究的是46例在印多尔市SAIMS神经科入院的患者,他们首次发生缺血性中风且发病时间在72小时内。所有发病时间超过72小时、有感染及围产期中风病史的患者均被排除在研究之外。通过NIHSS进行残疾评分,并使用市售的定量夹心酶联免疫吸附测定试剂盒对他们的血清样本检测高敏C反应蛋白(hsCRP)、白细胞介素6(IL6)。还对50例对照病例(包括健康志愿者和SAIMS的工作人员)的血清样本进行了hsCRP、IL6分析以作对比研究。入院时观察到NIHSS评分与血清hsCRP和IL6之间存在显著相关性。初始血清IL6和hsCRP水平高的患者在入院7天后通过NIHSS评分评估也显示出明显的临床恶化。在印度的研究人群中,入院72小时内hsCRP和IL6升高与功能残疾密切相关,在急诊情况下可能作为CT扫描的有用辅助手段。

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