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探讨急性脑卒中急性期一氧化氮（ＮＯ）和炎性细胞因子的变化与ＧＣＳ及预后的关系。方法采用硝酸还原酶法和生物素链亲和素ＥＬＩＳＡ法测定了９０例急性脑卒中患者７２ｈ内血清ＮＯ、肿瘤坏死因子（ＴＮＦα）、白细胞介素６（ＩＬ－６）、白细胞介素８（ＩＬ－８）含量，对出血性卒中同时记录ＧＣＳ及血白细胞（ＷＢＣ）计数。结果不论卒中类型，全部患者血清ＮＯ均低于对照组（Ｐ＜０．０５），并且随脑出血容积增大递减。脑梗塞及脑出血≤２０ｍｌ组ＴＮＦα有增高趋势（Ｐ＞０．０５），其它各组均显著增高（Ｐ＜０．０１）。全部患者ＩＬ－６及ＩＬ－８均显著增高（Ｐ＜０．０１）。出血性卒中ＧＣＳ＞８分及ＧＣＳ≤８分组ＩＬ－６、ＩＬ－８及血ＷＢＣ均有显著差异，前者死亡率为３％（１／３５），后者死亡率为６４％（１６／２５）。结论细胞因子参与了脑卒中急性期病理生理过程，细胞因子和白细胞早期增高预示病情的严重程度及预后不良。
To investigate the relationship between the changes of nitric oxide (NO) and inflammatory cytokines in acute stroke and GCS and prognosis. Methods Serum levels of NO, TNFα, IL-6, IL-8, IL-6 and IL-6 in 72 patients with acute stroke were measured by nitric acid reductase and biotinylated streptavidin- IL-8) content, hemorrhagic stroke simultaneously recorded GCS and white blood cell (WBC) count. Results Regardless of the type of stroke, serum NO in all patients was lower than that in the control group (P <0.05), and decreased as the volume of cerebral hemorrhage increased. The levels of TNFα in cerebral infarction and intracerebral hemorrhage≤20ml group increased (P> 0.05), while the other groups were significantly increased (P <0.01). All patients IL-6 and IL-8 were significantly higher (P <0.01). Hemorrhagic stroke GCS> 8 points and GCS≤8 group IL-6, IL-8 and blood WBC were significantly different, the former mortality rate was 3% (1/35), the latter was 64% (16/25 ). Conclusions Cytokines are involved in the pathophysiology of acute stroke. The early increase of cytokines and leukocytes indicates the severity of the disease and the poor prognosis.