摘要
目的探讨老年急性脑梗死(ACI)患者血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶-9(MMP-9)及超敏C反应蛋白(hs-CRP)的表达水平与颈动脉粥样硬化和预后不良的关系。方法保定市第二中心医院收治的老年ACI患者162例,经颈动脉超声检查分为无斑块组(n=31),稳定斑块组(n=55)及不稳定斑块组(n=76)。根据梗死体积不同分为小梗死组(n=52)、中梗死组(n=60)和大梗死组(n=50)。检测各组患者血清IL-6,TNF-α,MMP-9及hs-CRP水平,并进行比较。应用ROC曲线分析血清IL-6,TNF-α,MMP-9及hs-CRP预测老年ACI患者预后不良的价值。结果小梗死组、中梗死组和大梗死组血清IL-6(26.92±4.15,52.73±7.58和75.30±13.74ng/L),TNF-α(12.50±2.14和18.27±2.38,30.26±4.68ng/L),MMP-9(125.60±41.74,160.28±50.37和202.54±60.93μg/L)及hs-CRP(3.25±0.53,6.74±1.56和10.18±3.15mg/L)水平依次增高,各组间比较差异均有统计学意义(F=10.182,12.308,5.974,6.283,均P<0.05)。无斑块组、稳定斑块组和不稳定斑块组血清IL-6(28.26±4.25,49.30±7.16和68.42±11.58ng/L),TNF-α(14.36±2.15,20.48±2.73和28.24±4.12ng/L),MMP-9(130.42±43.26,158.40±51.25和197.63±61.45μg/L)及hs-CRP(3.40±0.56,6.81±1.60和9.34±2.72mg/L)水平依次增高,各组间比较差异均有统计学意义(F=7.248,8.605,5.209,5.426,均P<0.05)。Ⅰ级组、Ⅱ级组和Ⅲ级组血清IL-6(30.14±4.38,53.27±7.62和74.25±14.20ng/L),TNF-α(15.27±2.26,21.43±2.60和30.13±4.75ng/L),MMP-9(127.42±40.63,165.70±52.32和210.16±59.13μg/L)及hs-CRP(3.51±0.62,6.90±1.65和9.86±3.07mg/L)水平依次增高,各组间比较差异均有统计学意义(F=9.603,10.214,7.206,5.816,均P<0.05)。预后不良组血清IL-6,TNF-α,MMP-9及hs-CRP水平明显高于预后良好组(P<0.05)。四项联合预测ACI患者预后不良的AUC(0.894,95%CI:0.832~0.955)均明显高于单项,其敏感度和特异度为91.6%和81.7%。结论 IL-6,TNF-α,MMP-9及hs-CRP水平与老年ACI患者颈动脉粥样硬化严重程度�
Objective To investigate the relationship between the levels of serum interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α),matrix metalloproteinase-9(MMP-9) and hypersensitive C-reactive protein(hs-CRP) and carotid atherosclerosis and poor prognosis in elderly patients with acute cerebral infarction(ACI).Methods 162 elderly patients with ACI admitted to the Second Central Hospital of Baoding were divided into non-plaque group(n=31),stable plaque group(n=55) and unstable plaque group(n=76).They were divided into small infarction group(n=52),middle infarction group(n=60) and large infarction group(n=50) according to the volume of infarction.The levels of serum IL-6,TNF-α,MMP-9 and hs-CRP were detected and compared.ROC curve was used to analyze the value of serum IL-6,TNF-α,MMP-9 and hs-CRP in predicting the poor prognosis of elderly ACI patients.Results Serum levels of IL-6(26.92±4.15,52.73±7.58 and 75.30±13.74 ng/L),TNF-α(12.50±2.14,18.27±2.38 and 30.26±4.68 ng/L),MMP-9(125.60±41.74,160.28±50.37 and 202.54±60.93 μg/L) and hs-CRP(3.25±0.53,6.74±1.56 and 10.18±3.15 mg/L) in small infarction group,middle infarction group and large infarction group increased in turn,and there were significant differences among groups(F=10.182,12.308,5.974,6.283,all P<0.05).The serum levels of IL-6(28.26±4.25,49.30±7.16 and 68.42±11.58 ng/L),TNF-α(14.36±2.15,20.48±2.73 and 28.24±4.12 ng/L),MMP-9(130.42±43.26,158.40±51.25 and 197.63±61.45μg/L) and hs-CRP(3.40±0.56,6.81±1.60 and 9.34±2.72 mg/L) in non-plaque group,stable plaque group and unstable plaque group increased in turn,and there was significant difference among the groups(F=7.248,8.605,5.209,5.426,all P<0.05).Serum levels of IL-6(30.14±4.38,53.27±7.62 and 74.25±14.20 ng/L),TNF-α(15.27±2.26,21.43±2.60 and 30.13±4.75 ng/L),MMP-9(127.42±40.63,165.70±52.32 and 210.16±59.13 μg/L) and hs-CRP(3.51±0.62,6.90±1.65 and 9.86±3.07 mg/L) in grade I,grade II and grade III groups increased in turn,and there were significant differences among groups
作者
耿彪
宋婷阁
张鹏举
姚伟莉
GENG Biao;SONG Ting-ge;ZHANG Peng-ju;YAO Wei-li(Department of Blood Transfusion,Baoding Second Central Hospital,Hebei Zhuo Zhou 072750,China)
出处
《现代检验医学杂志》
CAS
2019年第4期120-123,127,共5页
Journal of Modern Laboratory Medicine
关键词
老年急性脑梗死
白细胞介素-6
肿瘤坏死因子-α
基质金属蛋白酶-9
超敏C反应蛋白
颈动脉粥样硬化
elderly patients with acute cerebral infarction
interleukin-6
tumor necrosis factor-alpha
matrix metalloproteinase-9
high sensitivity C reactive protein
carotid atherosclerosis
