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目的观察颈动脉斑块稳定性对脑梗死急性期炎症因子及神经功能缺损的影响。方法将2008年1月至2010年10月首都医科大学宣武医院神经内科符合研究标准的首发脑梗死的153例患者根据颈动脉超声情况分为稳定斑块组69例和不稳定斑块组84例。检测患者血清白介素-1(IL-1)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶-9(MMP-9),并对其神经功能缺损、日常活动能力和认知功能进行评估。结果不稳定斑块组血清IL-6、TNF-α、MMP-9高于稳定斑块组(P<0.05)。不稳定斑块组NIHSS评分明显高于稳定斑块组(P<0.01),BARTHEL指数、MMSE评分明显低于稳定斑块组(P<0.05)。结论脑梗死伴不稳定斑块患者血清IL-6、TNF-α、MMP-9等炎症因子水平较高,其神经功能缺损较重,日常生活能力和认知功能状况亦较差。
Objective To observe the effects of carotid plaque stability on inflammatory factors and neurological deficits in acute cerebral infarction. Methods From January 2008 to October 2010, 153 patients with first-degree cerebral infarction who meet the research criteria of Department of Neurology, Xuanwu Hospital, Capital Medical University were divided into stable plaque group (n = 69) and unstable plaque group (n = 84) . Serum levels of interleukin-1, interleukin-6, tumor necrosis factor-α (TNF-α) and matrix metalloproteinase-9 (MMP-9) were measured and their neurological deficits, Daily activity ability and cognitive function are evaluated. Results The levels of IL-6, TNF-α and MMP-9 in unstable plaque group were significantly higher than those in stable plaque group (P <0.05). The NIHSS score in unstable plaque group was significantly higher than that in stable plaque group (P <0.01). The BARTHEL index and MMSE score were significantly lower than those in stable plaque group (P <0.05). Conclusion Serum levels of IL-6, TNF-α, MMP-9 and other inflammatory cytokines in patients with cerebral infarction and unstable plaques are higher than those in normal controls. Their neurological deficits are severe and their daily living ability and cognitive function are also poor.