【摘 要】
：
目的：探讨血浆IL-6、TNF-α水平是否与脑白质病变的发病及严重程度相关,为脑白质病变的治疗和预防提供新的思路.方法：选取发病至入院时间≤14d的缺血性卒中患者和年龄性别匹配的体检人员共140例,分为脑梗死组、单纯脑白质病变组和对照组,对照组为体检未发现脑白质病变的患者;脑梗死组根据TOAST分型分为小动脉病变性脑梗死(有或无脑白质病变)组、大动脉硬化性脑梗死合并脑白质病变组、单纯大动脉硬化性脑
【机 构】
：
中山大学附属第一医院神经科,广东广州 510080;广州新海医院神经科,广东广州 510300 珠
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目的：探讨血浆IL-6、TNF-α水平是否与脑白质病变的发病及严重程度相关,为脑白质病变的治疗和预防提供新的思路.
方法：选取发病至入院时间≤14d的缺血性卒中患者和年龄性别匹配的体检人员共140例,分为脑梗死组、单纯脑白质病变组和对照组,对照组为体检未发现脑白质病变的患者;脑梗死组根据TOAST分型分为小动脉病变性脑梗死(有或无脑白质病变)组、大动脉硬化性脑梗死合并脑白质病变组、单纯大动脉硬化性脑梗死组;各组进行血浆IL-6、TNF-α、血常规、空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇等生化检查及头颅CT、MRI等影像学检查.
结果：小动脉病变性脑梗死组和单纯脑白质病变组的血浆IL-6、TNF-α浓度统计学差异有意义(P=0.048,P＜0.05);单纯脑白质病变组和对照组的血浆IL-6、TNF-α浓度相比统计学差异有意义(P=0.013,P＜0.05);在单纯脑白质病变组和对照组中,对血浆IL-6、TNF-α浓度、年龄、空腹血糖、TG、CHO、LDL-C、HDL-C进行Logistic回归多因素分析,显示血浆TNF-α浓度(OR=2.673,P＜0.05)和年龄(OR=3.803,P＜0.05)是脑白质病变的独立危险因素;脑白质病变根据LA分级,只有LA0级和LA1、LA2、LA3、LA4级组间血浆IL-6、TNF-α水平相比具有统计学意义(P=0.000,P＜0.05).
结论：炎症反应可能参与脑白质病变的发病,但血浆IL-6、TNF-α水平尚不能反应脑白质病变的严重程度.
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