目的 :探讨急性脑梗死 (ACI)中医辨证分型与细胞因子介导的免疫损伤的关系。方法 :采用电化学发光免疫技术对 6 0例 ACI患者治疗前后的肿瘤坏死因子 α(TNFα)、白介素 2受体 (IL 2 R)、白介素 6(IL 6 )水平进行检测并作对照分析。结果 :ACI患者治疗前后 TNFα、IL 2 R、IL 6均显著高于健康对照组(P均 <0 .0 1) ,治疗后 TNFα、IL 2 R、IL 6均明显降低 ,与治疗前比较均有显著性差异 (P均 <0 .0 5 ) ;中脏腑患者 TNFα、IL 2 R和 IL 6水平均明显高于中经络组 (P均 <0 .0 5 ) ;风痰瘀阻、痰热痹阻、肝阳上亢型患者 TNFα、IL 2 R、IL 6活性水平均显著高于阴虚风动和气虚血瘀型 ,差异有显著性 (P均 <0 .0 1)。结论 :中风病的致病因素、病情轻重和辨证分型与 TNFα、IL 2 R、IL 6介导的炎性反应、神经内分泌和免疫网络功能的失调密切相关。 Objective: To investigate the relationship between TCM syndrome differentiation and cytokine mediated immune injury in acute cerebral infarction (ACI). Methods: The levels of tumor necrosis factor α (TNFα), interleukin 2 receptor (IL 2 R) and interleukin 6 (IL 6) in 60 ACI patients before and after treatment were detected by electrochemiluminescence immunoassay and compared with each other. Results: The levels of TNFα, IL 2 R and IL 6 in patients with ACI before and after treatment were significantly higher than those in healthy controls (all P <0.01), and the levels of TNFα, IL 2 R and IL 6 were significantly decreased after treatment (P <0.05). The levels of TNFα, IL 2 R and IL 6 in patients with middle-viscera were significantly higher than those in middle-meridian group (all P <0.05) The levels of TNFα, IL 2 R and IL 6 in patients with Bi-obstruction and hyperactivity of liver-yang type were significantly higher than those with Yin deficiency and blood stasis type (P <0.01). CONCLUSIONS: The causative factors, severity of disease and syndrome differentiation of stroke are closely related to the imbalance of TNFα, IL 2 R and IL 6-mediated inflammatory responses, neuroendocrine and immune network functions.