摘要： 目的 探讨急性缺血性卒中患者血清炎性因子及美国国立卫生研究院卒中量表（NIHSS）评分变化对病情评价的临床意义。方法 分别检测90 例急性缺血性卒中患者治疗前后血清白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、超敏C-反应蛋白（hs-CRP）水平和NIHSS 评分变化，并与正常对照受试者进行比较。结果根据梗死灶体积将患者分为大型（> 10 cm3）、中型（5 ~ 10 cm3）和小型（< 5 cm3）共3 个亚组，治疗前3 组患者血清IL-6、TNF-α和hs-CRP 水平均高于正常对照组（P < 0.01），治疗后各项炎性因子和NIHSS 评分降低，与治疗前差异仍有统计学意义（均P < 0.01）。结论 血清炎性因子水平和NIHSS评分可作为急性缺血性卒中患者的病情评价和疗效监测指标。

关键词: 脑缺血, 白细胞介素6, 肿瘤坏死因子α, C 反应蛋白质

Abstract: Objective  To explore the changes of serum inflammatory cytokines and National Institute of Health Stroke Scale (NIHSS) score in acute ischemic stroke patients and their clinical significances on patients' condition assessment.  Methods  The serum levels of three cytokines, including interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and high-sensitivity C-reactive protein (hs-CRP), were measured and compared between 90 acute ischemic stroke patients (ischemic stroke group) and 50 healthy people (normal control group). The above-mentioned three cytokines and NIHSS scores were compared between before and after treatment in ischemic stroke group.  Results  Patients in ischemic stroke group were divided into three subgroups according to different infarct sizes: large (> 10 cm3), medium (5-10 cm3) and small (< 5 cm3). The serum levels of three cytokines were significantly higher in three subgroups than those in the normal control group before treatment (P < 0.01). Compared with before treatment, both the serum levels of three cytokines and the NIHSS scores in ishemic stroke patients reduced significantly after treatment (P < 0.01, for all).  Conclusion  Serum levels of inflammatory cytokines and NIHSS scores in patients with acute ischemic stroke can be used for condition assessment and efficacy monitoring.

Key words: Brain ischemia, Interleukin-6, Tumor necrosis factor-alpha, C-reactive protein