Department of Neurology, Ruijin Hospital, School of Medicine, Shanghai, China.
Int J Med Sci. 2013 Aug 22;10(10):1399-405. doi: 10.7150/ijms.6652. eCollection 2013.
The difference of inflammatory response between the pathogenesis of cerebral large- and small vessel disease after stroke remains unclear. In present study, we aim to determine the association of circulating inflammatory markers with different stroke subtype.
99 patients with non-cardioembolic stroke were divided into large artery atherosclerosis (LAA) and small-artery occlusion (SAO) according to TOAST classification. A panel of plasma inflammatory markers including leukocyte, lymphocyte, CRP, fibrinogen, D-dimer, CD40L, IFN-γ, IL-1α, IL-1β, IL-6, IL-8, IL-17 and TNF-α were measured within 72 hours following cerebral ischemia. The relation of their levels in plasma with stroke subtype was further studied. All statistical data analysis was performed by SPSS 17.0 software.
We found that only CRP were closely associated with stroke subtype (p<0.05). Compared to SAO subgroup, the plasma levels of CRP was higher in LAA subgroup (p<0.05). The predictive efficiency of CRP more than 3.2 for LAA was 85.7% sensitivity. The influencing factor of CRP includes IL-6, lymphocyte, fibrinogen and D-dimer.
LAA had a stronger activation of inflammation than SAO in the pathogenesis, which was associated with the changes of CRP.
脑卒中后大血管病变和小血管病变发病机制中的炎症反应差异尚不清楚。本研究旨在确定循环炎症标志物与不同脑卒中亚型的关系。
99 例非心源性脑卒患者根据 TOAST 分类分为大动脉粥样硬化型(LAA)和小动脉闭塞型(SAO)。在脑缺血后 72 小时内检测了一组包括白细胞、淋巴细胞、CRP、纤维蛋白原、D-二聚体、CD40L、IFN-γ、IL-1α、IL-1β、IL-6、IL-8、IL-17 和 TNF-α的血浆炎症标志物。进一步研究了它们在血浆中的水平与脑卒中亚型的关系。所有统计数据分析均采用 SPSS 17.0 软件进行。
我们发现只有 CRP 与脑卒中亚型密切相关(p<0.05)。与 SAO 亚组相比,LAA 亚组的 CRP 血浆水平更高(p<0.05)。CRP 超过 3.2 对 LAA 的预测效率为 85.7%。CRP 的影响因素包括 IL-6、淋巴细胞、纤维蛋白原和 D-二聚体。
在发病机制中,LAA 比 SAO 有更强的炎症激活,这与 CRP 的变化有关。