Bokhari Faraz Ahmed, Shakoori Tania A, Butt Ambreen, Ghafoor Farkhanda
Department of Physiology, Shaikh Zayet medical Complex, University of Health Sciences, Lahore, Pakistan.
J Ayub Med Coll Abbottabad. 2014 Apr-Jun;26(2):111-4.
Inflammatory markers are being explored to aid in stroke diagnosis especially, to differentiate between clinical varieties of stroke. This study aimed to compare plasma tumour necrosis factor-alpha (TNF-alpha) and Interleukin-10 (IL-10) levels between stroke patients and controls, as well as between hemorrhagic and ischemic varieties of stroke.
Stroke patients who were admitted to Shaikh Zayed Hospital Lahore and Services Hospital Lahore, Pakistan within 24 hours after the onset of stroke symptoms were consecutively asked to participate in this study from June 2011 to December 2011.Venous blood samples were collected within 24 hours of stroke symptoms onset. Plasma TNF-α levels and IL-10 were calculated using commercial enzyme-linked immune-sorbent assay (ELISA). Cytokines levels were dichotomized as detectable yes/no and were compared between different groups using chi square test. Continuous variables were compared using the student t-test. Logistic regression model was used to investigate the effect of various risk factors on stroke subtypes. A value of p < 0.05 was considered significant.
One hundred and thirty one stroke patients were included in the study, out of which 93 were ischemic and 38 were haemorrhagic stroke patients. Forty-seven healthy asymptomatic individuals were included .as controls Plasma TNF-α levels (p < 0.001, r = 0.503, CI: 18.197-1672.950) were significantly elevated in stroke patients as compared to controls, along with advancing age (p = 0.002, r = 0.310, CI: 1.025-1.110) and history of hypertension (p = 0.002, r = 0.265, CI: 1.746-12.511). Males were found to be at a higher risk of developing stroke. Furthermore, history of hypertension (p=0.019, r= -0.294, CI: 0.134-1.500) and detectable TNF- levels (p = 0.002, r = 0.319, CI: 2.106-23.725) were found to be significantly different between ischemic and haemorrhagic stroke patients.
TNF-α level differed highly significantly between stroke and controls, and also between ischemic and haemorrhagic stroke subtypes.
目前正在探索炎症标志物以辅助中风诊断，尤其是用于区分不同临床类型的中风。本研究旨在比较中风患者与对照组之间以及出血性和缺血性中风类型之间的血浆肿瘤坏死因子-α（TNF-α）和白细胞介素-10（IL-10）水平。
2011年6月至2011年12月期间，连续邀请在巴基斯坦拉合尔的谢赫扎耶德医院和拉合尔服务医院中风症状发作后24小时内入院的中风患者参与本研究。在中风症状发作后24小时内采集静脉血样。使用商业酶联免疫吸附测定（ELISA）计算血浆TNF-α水平和IL-10水平。细胞因子水平分为可检测到/未检测到，并使用卡方检验在不同组之间进行比较。连续变量使用学生t检验进行比较。使用逻辑回归模型研究各种危险因素对中风亚型的影响。p < 0.05的值被认为具有统计学意义。
本研究纳入了131例中风患者，其中93例为缺血性中风患者，38例为出血性中风患者。纳入47名健康无症状个体作为对照。与对照组相比，中风患者的血浆TNF-α水平（p < 0.001，r = 0.503，CI：18.197 - 1672.950）显著升高，同时随着年龄增长（p = 0.002，r = 0.310，CI：1.025 - 1.110）和有高血压病史（p = 0.002，r = 0.265，CI：1.746 - 12.511）而升高。发现男性患中风的风险更高。此外，缺血性和出血性中风患者之间的高血压病史（p = 0.019，r = -0.294，CI：0.134 - 1.500）和可检测到的TNF水平（p = 0.002，r = 0.319，CI：2.106 - 23.725）存在显著差异。
中风患者与对照组之间以及缺血性和出血性中风亚型之间的TNF-α水平差异非常显著。
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