Arponen Otso, Muuronen Antti, Taina Mikko, Sipola Petri, Hedman Marja, Jäkälä Pekka, Vanninen Ritva, Pulkki Kari, Mustonen Pirjo
Kuopio University Hospital, Diagnostic Imaging Centre, Department of Clinical Radiology, Kuopio, Finland; University of Eastern Finland, Institute of Clinical Medicine, Unit of Radiology, Kuopio, Finland.
Kuopio University Hospital, Diagnostic Imaging Centre, Department of Clinical Radiology, Kuopio, Finland.
PLoS One. 2015 Apr 29;10(4):e0120910. doi: 10.1371/journal.pone.0120910. eCollection 2015.
Etiological assessment of stroke is essential for accurate treatment decisions and for secondary prevention of recurrence. There is evidence that interleukin-10 (IL-10) associates with ischemic stroke. The aim of this prospective study was to assess the levels of IL-10 in ischemic stroke with unknown or suspected cardiogenic etiology, and evaluate the correlation between IL-10 plasma concentration and the number of diagnosed high risk sources for cardioembolism.
A total of 141 patients (97 males; mean age 61±11 years) with acute ischemic stroke with unknown etiology or suspected cardiogenic etiology other than known atrial fibrillation (AF) underwent imaging investigations to assess high risk sources for cardioembolic stroke established by the European Association of Echocardiography (EAE). IL-10 was measured on admission to the hospital and on a three month follow-up visit.
Acute phase IL-10 concentration was higher in patients with EAE high risk sources, and correlated with their number (p<0.01). In patients with no risk sources (n = 104), the mean IL-10 concentration was 2.7±3.1 ng/L (range 0.3-16.3 ng/L), with one risk source (n = 26) 3.7±5.5 ng/L (0.3-23.6 ng/L), with two risk sources (n = 10) 7.0±10.0 ng/L (1.29-34.8 ng/L) and with three risk sources (n = 1) 37.2 ng/L. IL-10 level was not significantly associated with cerebral infarct volume, presence of previous or recent myocardial infarction, carotid/vertebral artery atherosclerosis, paroxysmal AF registered on 24-hour ECG Holter monitoring or given intravenous thrombolytic treatment.
IL-10 plasma concentration correlates independently with the number of EAE cardioembolic risk sources in patients with acute stroke. IL-10 may have potential to improve differential diagnostics of stroke with unknown etiology.
卒中的病因学评估对于准确的治疗决策和复发的二级预防至关重要。有证据表明白细胞介素-10（IL-10）与缺血性卒中有关。这项前瞻性研究的目的是评估病因不明或疑似心源性病因的缺血性卒中患者的IL-10水平，并评估IL-10血浆浓度与已诊断的心源性栓塞高危因素数量之间的相关性。
共有141例病因不明或疑似心源性病因（已知心房颤动（AF）除外）的急性缺血性卒中患者接受了影像学检查，以评估由欧洲超声心动图协会（EAE）确定的心源性栓塞性卒中高危因素。在入院时和三个月的随访中测量IL-10。
EAE高危因素患者的急性期IL-10浓度较高，且与高危因素数量相关（p<0.01）。在无高危因素的患者（n = 104）中，平均IL-10浓度为2.7±3.1 ng/L（范围0.3-16.3 ng/L），有一个高危因素的患者（n = 26）为3.7±5.5 ng/L（0.3-23.6 ng/L），有两个高危因素的患者（n = 10）为7.0±10.0 ng/L（范围1.29-34.8 ng/L），有三个高危因素的患者（n = 1）为37.2 ng/L。IL-10水平与脑梗死体积、既往或近期心肌梗死的存在、颈动脉/椎动脉粥样硬化、24小时心电图动态监测记录的阵发性AF或接受静脉溶栓治疗均无显著相关性。
急性卒中患者的IL-10血浆浓度与EAE心源性栓塞高危因素数量独立相关。IL-10可能有助于改善病因不明的卒中的鉴别诊断。
