Osipova O A, Gosteva E V, Belousova O N, Zhernakova N I, Klushnikov N I, Golovina N I
Belgorod State National Research University, 85 Pobedy str., Belgorod 308015, Russian Federation, е-mail:
N.N.Burdenko Voronezh State Medical University, 10 Studencheskaya str., Voronezh 394036, Russian Federation.
Adv Gerontol. 2021;34(6):879-884.
The article deals with the development of fibrosis and immune inflammation in patients with arterial hypertension and acute ischemic stroke in old age. The aim of the study was to study age-associated features of the concentration of fibrosis markers (metalloproteinase-9, tissue inhibitor of matrix metalloproteinases-1, their ratio MMP-9/TIMP-1), immune inflammation (TNF-α, IL-1β, INF-γ) in patients with arterial hypertension and ischemic stroke (AI). The study included 86 patients with arterial hypertension (AH) of the 2nd degree, of which 42 were middle-aged (53±5 years) and 44 elderly (66±5 years). The control group consisted of 22 elderly patients with AH without a history of AI. The criteria for inclusion in the study are patients with hypertension who were admitted to the hospital in the acute period of the first cerebral stroke. It was found that in elderly patients with hypertension with AI, the indicators of inflamaging and fibrosis markers were significantly higher than in middle-aged people. The level of IL-1ß was 31,7% higher (p<0,01), TNF-α by 55,7% (p<0,001), INF-γ by 36,6% (p<0,01), the level of MMP-9 was 46,4% higher (p<0,01), TIMP-1 by 21,2% (p<0,01), MMP-9/TIMP-1 by 19,6% (p<0,01) in the elderly compared to middle-aged patients with hypertension and acute AI. Thus, it was found that patients with arterial hypertension and ischemic stroke have violations of the processes of inflamaging, synthesis and degradation of the extracellular matrix, especially pronounced in old age.
本文探讨老年动脉高血压患者合并急性缺血性卒中时纤维化和免疫炎症的发展情况。本研究旨在研究动脉高血压合并缺血性卒中（AI）患者中纤维化标志物（金属蛋白酶-9、基质金属蛋白酶组织抑制剂-1及其比值MMP-9/TIMP-1）、免疫炎症（TNF-α、IL-1β、INF-γ）浓度与年龄相关的特征。该研究纳入了86例二级动脉高血压（AH）患者，其中42例为中年患者（53±5岁），44例为老年患者（66±5岁）。对照组由22例无AI病史的老年AH患者组成。纳入研究的标准为首次脑卒中急性期入院的高血压患者。研究发现，老年高血压合并AI患者的炎症衰老和纤维化标志物指标显著高于中年患者。与中年高血压合并急性AI患者相比，老年患者IL-1β水平高31.7%（p<0.01），TNF-α高55.7%（p<0.001），INF-γ高36.6%（p<0.01），MMP-9水平高46.4%（p<0.01），TIMP-1高21.2%（p<0.01），MMP-9/TIMP-1高19.6%（p<0.01）。因此，研究发现动脉高血压合并缺血性卒中患者存在炎症衰老、细胞外基质合成与降解过程的异常，在老年患者中尤为明显。
