CAJ | 학술논문

目的探讨血清白细胞介素(IL)-18、IL-1β、和肽素水平在急性脑梗死(ACI)中的动态变化,并分析其与ACI病情严重程度之间的关系.方法 83例ACI患者在发病后24 h内入院,分别在入院后(发病后)第1、3、7天抽取空腹静脉血,采用双抗体夹心酶联免疫吸附法检测血清IL-18、IL-1β、和肽素水平,采用欧洲卒中量表(ESS)评估ACI病情严重程度;同时选择32例健康体检者进行对照比较.结果 ACI患者发病后第1、3、7天血清IL-18水平分别为(131.30±31.62)、(168.30±28.12)、(141.26±24.23)ng/L,IL-1β水平分别为(0.35±0.04)、(0.82±0.10)、(0.52±0.21)μg/L,和肽素水平分别为(3.64±0.26)、(4.18±0.53)、(3.26±2.41)μg/L,各指标不同时间比较差异均有统计学意义(P＜0.05),且均明显高于健康体检者[(119.12±27.42)ng/L、(0.21±0.08)μg/L、(2.63±0.23)μg/L](P＜0.05).单因素Logistic回归分析结果显示,年龄、和肽素、IL-18、IL-1β、ESS评分为ACI患者病情严重程度的影响因素(P＜0.05);受试者工作特征曲线分析结果显示,IL-18对ACI患者病情严重程度的评估价值与年龄、和肽素、IL-1β、ESS评分的评估价值比较差异无统计学意义(P＞0.05).结论血清IL-18、IL-1β、和肽素水平在ACI发病后升高,说明应激刺激后启动炎性免疫因子和神经内分泌因子参与了ACI的发生、发展过程.血清IL-18、IL-1β、和肽素水平可作为ACI病情严重程度的有效判断指标.
목적 탐토혈청백세포개소(IL)-18、IL-1β、화태소수평재급성뇌경사(ACI)중적동태변화,병분석기여ACI병정엄중정도지간적관계.방법 83례ACI환자재발병후24 h내입원,분별재입원후(발병후)제1、3、7천추취공복정맥혈,채용쌍항체협심매련면역흡부법검측혈청IL-18、IL-1β、화태소수평,채용구주졸중량표(ESS)평고ACI병정엄중정도;동시선택32례건강체검자진행대조비교.결과 ACI환자발병후제1、3、7천혈청IL-18수평분별위(131.30±31.62)、(168.30±28.12)、(141.26±24.23)ng/L,IL-1β수평분별위(0.35±0.04)、(0.82±0.10)、(0.52±0.21)μg/L,화태소수평분별위(3.64±0.26)、(4.18±0.53)、(3.26±2.41)μg/L,각지표불동시간비교차이균유통계학의의(P＜0.05),차균명현고우건강체검자[(119.12±27.42)ng/L、(0.21±0.08)μg/L、(2.63±0.23)μg/L](P＜0.05).단인소Logistic회귀분석결과현시,년령、화태소、IL-18、IL-1β、ESS평분위ACI환자병정엄중정도적영향인소(P＜0.05);수시자공작특정곡선분석결과현시,IL-18대ACI환자병정엄중정도적평고개치여년령、화태소、IL-1β、ESS평분적평고개치비교차이무통계학의의(P＞0.05).결론 혈청IL-18、IL-1β、화태소수평재ACI발병후승고,설명응격자격후계동염성면역인자화신경내분비인자삼여료ACI적발생、발전과정.혈청IL-18、IL-1β、화태소수평가작위ACI병정엄중정도적유효판단지표.
Objective To investigate the dynamic changes of serum interleukin(IL)-18,IL-1β and copeptin in acute cerebral infarction(ACI),and analyze the relationship with the serious degree of ACI.Methods The levels of serum IL-18,IL-1β and copeptin were measured by Double-antibody sanduicb enzyme-linked immunosorbent assay(ELISA)in 83 patients with ACI who were admitted to the hospital within 24 h,and neurological impairment were evaluated by European stroke scale(ESS)at the 1st,3rd and 7th day respectively after hospitalization.At the same time,the patients with ACI were compared with 32 normal adults.Results The levels of serum IL-18,IL-1β and copeptin at the 1st,3rd and 7th day after hospitalization were(131.30±31.62),(168.30±28.12),(141.26±24.23)ng/L,(0.35±0.04),(0.82±0.10),(0.52±0.21)μ g/L,and(3.64±0.26),(4.18±0.53),(3.26±2.41)μ g/L respectively.There were significant differences among different times respectively(P＜0.05),furthermore they were higher than those in normal adults[(119.12±27.42)ng/L,(0.21±0.08)μ g/L,(2.63±0.23)μ g/L](P＜0.05).Univariate Logistic regression analysis showed that age,copeptin,IL-18,IL-1β and ESS score was the influencing factor in the serious degree of ACI.There was no significant difference in assessing the serious degree of ACI by receiver operating characteristic(ROC)curve between IL-18 and age,copeptin,IL-1 β,ESS score(P＞0.05).Conclusions The serum levels of IL-18,IL-1β and copeptin are increasing after ACI,indicating that the inflammatory and immune factors may be involved in the development process of ACI.The serum levels of IL-18,IL-1β and copeptin can reflect the serious degree of ACI.