凝血因子ⅩⅢ和细胞因子水平与脑卒中的相关性分析

摘要

目的 探讨凝血因子ⅩⅢ(FⅩⅢ)和细胞因子在脑卒中患者血液中的变化及临床意义.方法 以47例临床确诊的出血性脑卒中患者、183例临床确诊的缺血性脑卒中患者和50名体检健康者(对照组)为研究对象,检测各组FⅩⅢ、D-二聚体、抗凝血酶(AT)、纤溶酶原(PLG)水平,分析脑卒中与凝血系统指标的相关性.同时检测各研究对象白细胞介素6(IL-6)、白细胞介素10(IL-10)、肿瘤坏死因子α(TNF-α)的水平,初步探讨细胞因子与脑卒中的相关性.结果 出血性脑卒中和缺血性脑卒中患者的FⅩⅢ、PLG水平明显低于对照组(P<0.05),D-二聚体水平明显高于对照组(P<0.05),AT水平在2组间差异无统计学意义(P>0.05);出血性脑卒中患者D-二聚体水平高于缺血性脑卒中患者(P<0.05),FⅩⅢ、PLG、AT水平2组间差异无统计学意义(P>0.05).出血性脑卒中和缺血性脑卒中患者IL-6、IL-10、TNF-α的水平均高于对照组(P<0.05);出血性脑卒中患者IL-6水平高于缺血性脑卒中患者(P<0.05),IL-10、TNF-α水平在2组间差异无统计学意义(P>0.05).结论 FⅩⅢ、PLG、D-二聚体、IL-6、IL-10和TNF-α对脑卒中具有良好的辅助诊断价值,对早期诊断脑卒中、及早进行有针对性的治疗、降低脑卒中的致残率和致死率具有重要作用.%Objective To investigate the changes of coagulation factor ⅩⅢ(FⅩⅢ) and cytokines in stroke patients. Methods A total of 47 hemorrhagic stroke patients and 183 ischemic stroke patients were enrolled,and 50 healthy subjects were enrolled as healthy control group. The levels of FⅩⅢ,D-dimer,antithrombin(AT) and plasminogen(PLG) were determined,and the correlations of these coagulation system indices with stroke were analyzed. The levels of interleukin 6(IL-6),interleukin 10(IL-10) and tumor necrosis factor alpha(TNF-α) were determined,and the correlation of cytokines with stroke was analyzed.Results The levels of FⅩⅢ and PLG in patients with hemorrhagic stroke and ischemic stroke were lower than those in healthy control group(P<0.05), the levels of D-dimer were higher than that in healthy control group(P<0.05),and there was no statistical significance for the levels of AT between hemorrhagic stroke and ischemic stroke patients and healthy control group (P>0.05). The level of D-dimer in patients with hemorrhagic stroke was higher than that in patients with ischemic stroke(P<0.05). There was no statistical significance for the levels of FⅩⅢ,PLG and AT(P>0.05). The levels of IL-6,IL-10 and TNF-α in patients with hemorrhagic stroke and ischemic stroke were higher than those in healthy control group(P<0.05). The level of IL-6 in patients with hemorrhagic stroke was higher than that in patients with ischemic stroke(P<0.05). There was no statistical significance for the levels of IL-10 and TNF-α(P>0.05). Conclusions The levels of FⅩⅢ,PLG,D-dimer,IL-6,IL-10 and TNF-α play roles for the diagnosis of stroke, especially for the early diagnosis of stroke,early targeted treatment and reducing stroke morbidity and mortality.