血清炎症因子水平与进展性脑卒中的相关性研究

孙薇

[摘要] 目的 研究血清炎症因子水平与进展性脑卒中（PS）的相关性。 方法 选取我院神经内科2018年1月至2020年5月收诊的进展性脑卒中患者128例和非進展性脑卒中患者128例为研究对象，分别设为进展组、非进展组，选取同期体检的健康志愿者128例为对照组，对全部对象于入院第1天、第3天、第7天、第14天分别进行血清炎症因子（hs-CRP、IL-18、Ang-1、Lp-PLA2）水平的检测。 结果 进展组与非进展组患者的血清hs-CRP、Ang-1、Lp-PLA2水平均呈逐渐降低趋势，而血清IL-18水平呈先升后降趋势，且在入院第1天、第3天、第7天、第14天的各个指标值比较：进展组的hs-CRP、IL-18、Lp-PLA2水平均高于非进展组，且进展组的Ang-1水平高于非进展组，P<0.05;与对照组健康人比较：其中两组患者入院第1天、第3天、第7天的hs-CRP水平均高于对照组，P<0.05;但入院第14天时非进展组的hs-CRP水平与对照组差异不明显（P>0.05）;进展组在入院第1天、第3天、第7天、第14天的IL-18、Lp-PLA2水平均高于非进展组，且Ang-1水平低于非进展组，P<0.05;相关性分析发现：hs-CRP、IL-18、Lp-PLA2水平与进展性脑卒中呈正相关关系，P<0.05;Ang-1水平与进展性脑卒中呈负相关关系，P<0.05;多因素回归分析发现入院时的hs-CRP≥12.9 mg/L、IL-18≥115.7 pg/mL、Ang-1≤3.17 ng/mL、Lp-PLA2≥64.5 μg/mL都是进展性脑卒中的独立影响因素（P<0.05）。 结论 血清炎症因子水平与进展性脑卒中关系密切，血清hs-CRP、IL-18、Ang-1、Lp-PLA2水平均与进展性脑卒中相关，可作为预测进展性脑卒中的重要指标，便于指导临床医师早期检出进展性脑卒中时采取针对性方案干预治疗。

[关键词] 血清炎症因子;进展性脑卒中;hs-CRP;IL-18;Ang-1;Lp-PLA2;影响因子

[中图分类号] R743.3          [文献标识码] B          [文章编号] 1673-9701（2021）30-0070-04

[Abstract] Objective To investigate the correlation between serum inflammatory factor levels and progressive stroke（PS）. Methods A total of 128 patients with progressive stroke and 128 patients with non-progressive stroke admitted to the Department of Neurology of our hospital from January 2018 to May 2020 were selected and classified as the progressive group and the non-progressive group.A total of 128 healthy volunteers receiving physical examination during the same period were classified as the control group.Serum inflammatory factor（hs-CRP，IL-18，Ang-1 and Lp-PLA2）levels were assessed for all subjects on the 1st，3rd，7th，and 14th days of admission. Results The levels of serum hs-CRP，Ang-1，and Lp-PLA2 in the progressive group and the non-progressive group were decreased gradually，while the level of serum IL-18 was first increased and then decreased.Index values on the 1st，3rd，7th，and 14th days of admission were compared.The levels of hs-CRP，IL-18 and Lp-PLA2 in the progressive group were higher than those in the non-progressive group，and the Ang-1 level in the progressive group was higher than that in the non-progressive group（P<0.05）.Compared with healthy people in the control group，the levels of hs-CRP in the progressive group and the non-progressive group on the 1st，3rd，and 7th days of admission were higher than those in the control group（P<0.05）.However，there is no significant difference in the level of hs-CRP on the 14th day of admission between the non-progressive group and the control group（P>0.05）.The levels of IL-18 and Lp-PLA2 in the progression group on the 1st，3rd，7th，and 14th days of admission were higher than those in the non-progressive group，and the level of Ang-1 was lower than that in the non-progressive group（P<0.05）.Correlation analysis indicated that the levels of hs-CRP，IL-18 and Lp-PLA2 were positively correlated with progressive stroke（P<0.05），and the level of Ang-1 was negatively correlated with progressive stroke（P<0.05）.Multivariate regression analysis indicated that hs-CRP≥12.9 mg/L，IL-18≥115.7 pg/mL，Ang-1≤3.17 ng/mL，and Lp-PLA2≥64.5 μg/mL at admission were all independent influencing factors of progressive stroke（P<0.05）. Conclusion Serum inflammatory factor levels are closely related to progressive stroke.The levels of serum hs-CRP，IL-18，Ang-1 and Lp-PLA2 are related to progressive stroke and can be used as important indicators for predicting progressive stroke.It is convenient to guide clinicians to detect progressive stroke early and adopt targeted intervention treatment.

[Key words] Serum inflammatory factors;Progressive stroke;Hs-CRP;IL-18;Ang-1;Lp-PLA2;Influencing factors

脑卒中是神经内科的多发病，近年来发病患者呈逐年增加趋势。……