论文部分内容阅读
目的探讨颈动脉粥样硬化(AS)斑块所致狭窄程度及血清细胞因子变化与急性脑梗死患者认知功能的关系。方法根据颈AS斑块所致狭窄的程度将96例急性脑梗死患者分为5组,另设40例健康体检者为对照组。同时进行颈动脉彩超检查及简易智能精神状态检查量表(MMSE)评定,检测血清白细胞介素-10(IL-10)、白细胞介素-1β(IL-1β)、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶-9(MMP-9)的水平。结果急性脑梗死患者MMSE评分除Ⅰ级狭窄组外,其余各组总分均低于对照组(P<0.05);与对照组相比,Ⅱ级、Ⅲ级狭窄组在注意计算、回忆能力方面有显著降低(P<0.01),Ⅳ、Ⅴ级狭窄组在时间和地点定向力、记忆力、注意计算力、回忆、复述、阅读、书写、结构能力等9个方面有显著降低(P<0.05);与对照组相比,各组血清IL-1β、CRP、TNF-α水平随狭窄程度加重而逐渐升高(P<0.05),IL-10水平逐渐降低(P<0.05),MMP-9水平与颈动脉狭窄程度无相关性;脑梗死患者MMSE评分与IL-1β、CRP、TNF-α水平呈负相关(r=-0.348,r=-0.343,r=-0.454,均P<0.01),与IL-10水平成呈相关(r=0.696,P<0.01),与MMP-9水平无相关性。结论急性脑梗死患者血清IL-1β、CRP、TNF-α水平升高,且与颈AS狭窄程度呈正相关,IL-10水平下降与狭窄程度呈负相关;急性脑梗死颈动脉狭窄患者认知功能下降。
Objective To investigate the relationship between the degree of stenosis caused by carotid atherosclerosis (AS) plaque and the changes of serum cytokines in patients with acute cerebral infarction. Methods According to the degree of stenosis caused by cervical AS plaque, 96 patients with acute cerebral infarction were divided into 5 groups and another 40 healthy subjects were selected as the control group. At the same time, carotid color Doppler ultrasound examination and mini-mental state examination (MMSE) were used to evaluate the levels of serum IL-10, IL-1β, CRP, , Tumor necrosis factor-α (TNF-α) and matrix metalloproteinase-9 (MMP-9). Results The scores of MMSE in patients with acute cerebral infarction were significantly lower than those in control group (P <0.05) except grade Ⅰ stenosis group. Compared with the control group, the MMSE score of grade Ⅱ and Ⅲ stenosis group was significantly higher than that of control group (P <0.01). There was a significant decrease in orientation, memory, attentional calculation, memory, repetition, reading, writing and structure ability of the Ⅳ and Ⅴ stenosis group at the time and place Compared with the control group, the levels of IL-1β, CRP and TNF-α in each group increased gradually with the degree of stenosis (P <0.05), the levels of IL-10 decreased There was no correlation between the MMSE score and the level of IL-1β, CRP and TNF-α in patients with cerebral infarction (r = -0.348, r = -0.343, r = -0.454, all P <0.01) It was correlated with IL-10 level (r = 0.696, P <0.01), but not with MMP-9 level. Conclusions Serum levels of IL-1β, CRP and TNF-α in patients with acute cerebral infarction are elevated, and are positively correlated with the degree of AS neck stenosis. The decrease of IL-10 level is negatively correlated with the degree of stenosis. Acute cerebral infarction patients with carotid artery stenosis have cognitive function decline.