CAJ | 학술논문

背景:随着对急性脑梗死病理生理机制的深入探讨,发现炎症反应在中枢神经系统缺血性损伤中占有重要地位,其中肿瘤坏死因子α,白细胞介素1β和可溶性细胞间黏附分子1正成为研究的热点.目的:研究缺血性脑卒中患者血清中炎性细胞因子水平与病程,病情严重程度的关系.设计:以患者和健康人为研究对象,病例-对照研究.单位:武汉大学医院的神经内科.对象:2001-01/2003-12武汉大学人民医院神经内科住院和门诊缺血性脑卒中患者50例,其中男23例,女27例,平均年龄(60.26±8.77)岁.对照组40例为同期门诊体检的健康人,其中男18例,女22例,平均年龄(61.05±8.09)岁.干预:采用双抗体夹心酶联免疫吸附法测定血清肿瘤坏死因子α,白细胞介素1β,可溶性细胞间黏附分子1水平.主要观察指标:缺血性脑卒中患者病程不同时期、不同梗死体积、不同神经功能缺损程度血清中肿瘤坏死因子α,白细胞介素1β,可溶性细胞间黏附分子1水平.结果:急性期、恢复期脑梗死患者血清肿瘤坏死因子α,白细胞介素1β和可溶性细胞间黏附分子1水平较对照组显著增高(P＜0.01),急性期又较恢复期高(P＜0.05),增高程度与神经功能缺损程度及梗死体积大小密切相关,且血清中肿瘤坏死因子α含量与白细胞介素1β和可溶性细胞间黏附分子1也相关. 结论:肿瘤坏死因子α,白细胞介素1β和可溶性细胞间黏附分子1互相作用参与了急性脑梗死的炎症反应和再灌流损伤.对它们的监测可为早期临床治疗及康复干预提供试验指标,以便控制脑卒中的进展及复发.
배경:수착대급성뇌경사병리생리궤제적심입탐토,발현염증반응재중추신경계통결혈성손상중점유중요지위,기중종류배사인자α,백세포개소1β화가용성세포간점부분자1정성위연구적열점.목적:연구결혈성뇌졸중환자혈청중염성세포인자수평여병정,병정엄중정도적관계.설계:이환자화건강인위연구대상,병례-대조연구.단위:무한대학의원적신경내과.대상:2001-01/2003-12무한대학인민의원신경내과주원화문진결혈성뇌졸중환자50례,기중남23례,녀27례,평균년령(60.26±8.77)세.대조조40례위동기문진체검적건강인,기중남18례,녀22례,평균년령(61.05±8.09)세.간예:채용쌍항체협심매련면역흡부법측정혈청종류배사인자α,백세포개소1β,가용성세포간점부분자1수평.주요관찰지표:결혈성뇌졸중환자병정불동시기、불동경사체적、불동신경공능결손정도혈청중종류배사인자α,백세포개소1β,가용성세포간점부분자1수평.결과:급성기、회복기뇌경사환자혈청종류배사인자α,백세포개소1β화가용성세포간점부분자1수평교대조조현저증고(P＜0.01),급성기우교회복기고(P＜0.05),증고정도여신경공능결손정도급경사체적대소밀절상관,차혈청중종류배사인자α함량여백세포개소1β화가용성세포간점부분자1야상관. 결론:종류배사인자α,백세포개소1β화가용성세포간점부분자1호상작용삼여료급성뇌경사적염증반응화재관류손상.대타문적감측가위조기림상치료급강복간예제공시험지표,이편공제뇌졸중적진전급복발.
BACKGROUND: With the deep investigations of pathophysiological mechanism of acute cerebral infarction, it is discovered that inflammation occupies an important stance in the ischemic injuries of central nervous system ( CNS ), in which tumor necrosis factor-αt (TNF-α), interleukin- 1β(IL-1β), and soluble intercellular adhesion molecule(sICAM-1) become hotspots in the researches.OBJECTIVE: To investigate the relationship between the levels of serous inflammatory cell factors and the course of the disease, the severity of the situation in patients with ischemic stroke.DESIGN: A case-control study based on patients and healthy individuals.SETTING: Department of neurology in a university hospital.PARTICIPANTS: Fifty ischemic stroke patients including 23 males and 27 females with an average age of(60.26 ± 8.77) years old were selected from the outpatient and inpatient Departments of Neurology of the Renmin Hospital of Wuhan University between January 2001 and December 2003. Forty healthy controls including 18 males and 22 females with an average age of (61.05 ± 8.09) years old were selected from the subjects who had physical check up at outpatient department during corresponding period.INTERVENTIONS: Serous TNF-α, IL-1 β and sICAM-1 levels were detected by double-antibody-ELISA.MAIN OUTCOME MEASURES: Serous levels of TNF-α, IL-1β and sICAM-1 in patients with ischemic stroke of different stage, with different infarction volume and different neural functional defects.RESULTS: Serous TNF-α, IL-1β and sICAM-1 levels of patients with cerebral infarction during acute phase and convalescence were significant higher than that of control group( P ＜ 0.01 ), and the levels was significantly higher in acute phase than convalescence ( P ＜ 0.05 ) . The elevation was closely correlated with the degree of neural functional defect and the size of infarction volume, and furthermore, the serous content of TNF-α was also correlated with IL-1β and sICAM-1 levels.CONCLUSION: TNF-α, IL-1β and sICAM-1 interact and participate in the inflammation and reperfusion injury of acute cerebral infarction. Surveillance on them can provide experimental indicators for early clinical therapy and rehabilitative intervention, which is good for the control of the development and recurrence of stroke.