【作者】 江秀龙；

【导师】 季晓林；

【作者基本信息】 福建医科大学 ， 神经病学， 2007， 硕士

【摘要】 目的:分析急性脑梗死患者血清IL-6、TNFα、S-100b的动态变化规律及临床意义,探讨IL-6、TNFα、S-100b在急性脑梗死病理损伤中可能的作用机制。方法:选择发病24小时以内的符合试验入选条件的颈内动脉系统急性脑梗死患者58例,同时收集相匹配的同期体检者30例作为对照组,用ELISA法测定血清IL-6、TNFα、S-100b浓度。病例组进行动态监测(于发病第1d、3d、7d、14d抽血),并同时记录患者神经功能缺损评分(NIHSS)。所有急性脑梗死患者依据发病后48-72h的脑CT或MR扫描结果计算脑梗死体积。结果:1.急性脑梗死患者血清IL-6、TNFα、S-100b发病当天就明显增高,IL-6、TNFα发病后第1d即达高峰,S-100蛋白第3d达高峰。其后浓度随时间的推移逐渐下降。梗塞体积大的患者血清IL-6、TNFα、S-100b蛋白更高且持续时间更长。2.血清IL-6、TNFα、S-100b的峰值浓度和脑梗死体积、NIHSS评分呈正相关。3.发病后进展性脑卒中患者血清IL-6、TNFα和S-100b蛋白高峰水平高于无进展性脑卒中患者。结论:急性脑梗死患者血清IL-6、TNFα和S-100b蛋白水平升高,他们可能从不同环节参与脑缺血后病理损伤,与进展性脑卒中相关。血清水平值能够反映脑缺血后病理损伤的程度和脑梗死体积大小,可作为急性脑梗死病人病情加重的标志物。更多还原

【Abstract】 Abstrct:Objective:To analyze the changes and clinical significance of IL-6,TNFα, S-100b.and to explore their pathologic mechanism in the brain ischemia.Methods:58 patients consecutively admittied with first-ever ischemic cerebral infarction within the first 24 hours from onset were included,and 30 healthy subjects were selected as controls.The serum level of IL-6,TNFαand S-100b was measured by enzyme linked immunosorbent assay.All the paitents that experienced stroke were observed on the 1st,3rd,7th day,the severity of stroke was scored at the same time using the NIH stroke Scale(NIHSS).The subsequent volume of brain lesion as a consequence of stroke was measured by CT or MRI within 48-72h after the onset.Results:1.Both the serum levels of IL-6,TNFαand S-100b were significantly higher in patients within the first day after the onset than those of the contros.IL-6,TNFa attain the peaks within 24 hours after the attact,athough the S-100 peak was arrived on the 3rd day.They all decreased gradually after the peaks.2.There was a positive correlation between both the peak levels of IL-6,TNFαand S-100b and the infarct volume and NIHSS..3.Higher levels of IL-6,TNFαand S-100b in serum inpatients with neurological deterioration compared with paitents who retained clinically stable or improved course.Conclusion:The serum levels of IL-6,TNFαand S-100b were upregulated,which may take part in the pathogenesis of acute cerebal infarction by deferent parthway.The levels of IL-6,TNFαand S-100b may reflect both the degree of pathologic lesion and the infarct volum.They may be markes for outcome in acute ischemic stroke.更多还原