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目的观察超敏C反应蛋白(hs CRP)、白细胞介素(IL)-18、细胞间黏附分子-1(ICAM1)、基质金属蛋白酶(MMP)-9、脂蛋白相关磷脂酶A2(Lp-PLA2)血清水平变化与急性脑梗死多因素的关系。方法选择2012年7月-2014年6月收治的76例急性脑梗死患者作为研究对象。于患者发病第2天(急性期)及第15天(恢复期)检测血清hs CRP、IL-18、ICAM1、MMP-9、Lp-PLA2水平,采用多重线型回归模型分别观察炎性因子的变化程度与高血压病、糖尿病、冠状动脉粥样硬化性心脏病、吸烟史、颈部血管斑块、低密度脂蛋白、脑梗死面积、美国国立卫生研究院卒中量表(NIHSS)评分的关系。结果急性脑梗死患者急性期与恢复期各炎性因子变化水平与吸烟史、高血压、冠状动脉粥样硬化性心脏病、低密度脂蛋白、NIHSS评分无明显相关(P>0.05);hs CRP、ICAM1动态变化与脑梗死面积、糖尿病、颈动脉粥样硬化相关(P<0.05),Lp-PLA2的水平变化与脑梗死面积、颈动脉粥样硬化有明显相关性(P<0.05),IL-18动态变化与糖尿病、颈动脉粥样硬化相关(P<0.05),而MMP-9仅与脑梗死面积相关(P<0.05)。结论炎性因子血清水平变化与脑梗死患者的多种因素有关,其中梗死面积、糖尿病、颈动脉粥样硬化是影响其血清水平变化的主要因素。
Objective To investigate the expression of hs-CRP, ICAM1, MMP-9, Lp-PLA2 and lipoprotein-associated phospholipase A2 ) Serum levels of acute cerebral infarction and many factors. Methods A total of 76 patients with acute cerebral infarction from July 2012 to June 2014 were selected as the study subjects. Serum levels of hsCRP, IL-18, ICAM1, MMP-9 and Lp-PLA2 were detected on the second day (acute phase) and 15th day (convalescence) of the onset of the disease. Multiple linear regression models were used to observe the levels of inflammatory cytokines Relationship between changes and hypertension, diabetes mellitus, coronary heart disease, smoking history, neck plaque, LDL, infarct size, NIHSS score . Results The levels of inflammatory cytokines in acute and convalescent patients with acute cerebral infarction had no significant correlation with smoking history, hypertension, coronary atherosclerotic heart disease, low density lipoprotein, NIHSS score (P> 0.05); hs CRP (P <0.05). The level of Lp-PLA2 was significantly correlated with the area of cerebral infarction and carotid artery atherosclerosis (P <0.05), while the level of IL-2 was positively correlated with ICAM1 in cerebral infarction area, diabetes and carotid atherosclerosis -18 dynamic changes associated with diabetes, carotid atherosclerosis (P <0.05), while MMP-9 only with cerebral infarction area (P <0.05). Conclusion Serum levels of inflammatory cytokines are related to many factors in patients with cerebral infarction. Infarction area, diabetes mellitus and carotid atherosclerosis are the main factors affecting the changes of serum levels.