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中华脑血管病杂志(电子版)

中华脑血管病杂志(电子版) ›› 2020, Vol. 14 ›› Issue (01) : 55 -58. doi: 10.11817/j.issn.1673-9248.2020.01.011

所属专题： 文献；

临床研究

丁苯酞注射液对急性脑梗死患者血清IL-6、IL-1β、TNF-α及预后的影响
崔晓1, 孙慧勤1,†()   
  1. 1. 221000　江苏省徐州市中心医院神经内科
  • 收稿日期:2020-01-10 出版日期:2020-02-01
  • 通信作者: 孙慧勤
  • 基金资助:
    江苏省科技厅临床医学专项课题(BL2014028); 徐州市科技局项目(KC15SH078)

Effects of butylphthalide injection on serum IL-6, IL-1β, TNF-α and prognosis in patients with acute cerebral infarction

Xiao Cui1, Huiqin Sun1,†()   

  1. 1. Department of Neurology, Xuzhou central Hospital, the Xuzhou School of Clinical Medicine of Nanjing Medical University, Xuzhou 221000, China
  • Received:2020-01-10 Published:2020-02-01
  • Corresponding author: Huiqin Sun
  • About author:
    Corresponding author: Sun Huiqin, Email:
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崔晓, 孙慧勤. 丁苯酞注射液对急性脑梗死患者血清IL-6、IL-1β、TNF-α及预后的影响[J]. 中华脑血管病杂志(电子版), 2020, 14(01): 55-58.

Xiao Cui, Huiqin Sun. Effects of butylphthalide injection on serum IL-6, IL-1β, TNF-α and prognosis in patients with acute cerebral infarction[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2020, 14(01): 55-58.

目的

探讨丁苯酞注射液对急性脑梗死患者血清白介素（IL）-6、IL-1β、肿瘤坏死因子-α（TNF-α）水平的变化及预后的影响。

方法

选取徐州市中心医院神经内科2016年5月到2018年4月住院的急性脑梗死患者80例，按照入院先后随机分为对照组和治疗组各40例，对照组给予控制血压、控制血糖、降脂、抗血小板聚集等常规治疗，治疗组在对照组的基础上加用注射用丁苯酞治疗，2组均持续治疗14 d。分别于治疗前及治疗14 d后进行IL-6、IL-1β、TNF-α浓度测定和神经功能缺损评分（NIHSS评分），治疗前和治疗后3个月进行中文版蒙特利尔认知量表（MOCA）评分。采用χ2检验比较组间总有效率和性别的差异，采用独立样本t检验比较组间血清IL-6、IL-1β、TNF-α浓度、NIHSS评分及MOCA评分的差异。

结果

2组患者治疗前IL-6、IL-1β、TNF-α浓度及NIHSS、MOCA评分差异均无统计学意义（P＞0.05）；治疗14 d后，治疗组IL-6、IL-1β、TNF-α浓度较对照组降低［（6.29±1.72）pg/ml vs （7.78±1.97）pg/ml；（13.40±1.20）ng/L vs （18.12±1.30）ng/L；（1.28±0.35）pg/ml vs （1.43±0.32）pg/ml］，差异均具有统计学意义（t=3.586、16.875、2.002，P=0.001、＜0.001、=0.049）；治疗组NIHSS评分较对照组显著下降［（4.80±1.24）分vs（6.80±1.95）分］，差异具有统计学意义（t=5.467，P＜0.001）；3个月后MOCA评分较对照组升高［（26.38±1.60）分 vs （25.03±2.36）分］，差异具有统计学意义（t=-2.998，P=0.004）。

结论

丁苯酞注射液有助于减少急性脑梗死患者的IL-6、IL-1β、TNF-α分泌，从而改善急性脑梗死患者的预后。

关键词: 脑梗死, 丁苯酞, 急性期, 细胞因子类, 白介素-6, 白介素-1β, 肿瘤坏死因子-α
Objective

To investigate the effects of butylphthalide injection on serum interleukin-6 (IL-6), interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) levels and the impact of prognosis in patients with acute cerebral infarction.

Methods

80 patients with acute cerebral infarction who were hospitalized in Xuzhou Central Hospital from May 2016 to April 2018 were randomly divided into control group and treatment group, each with 40 cases. The control group was given conventional treatments such as blood pressure control, blood glucose control, lipid lowering, and anti-platelet aggregation. In addition of the conventional treatments, butylphthalide for injection was added for 14 days. The concentrations of IL-6, IL-1β, TNF-α and the National Institutes of Health Stroke Scate scores were measured before and 14 days after treatment. MOCA score were performed before and 3 months after treatment. The χ2 test was used to compare the differences in total effectiveness and gender, and the independent sample t test was used to compare the differences in serum IL-6, IL-1β, TNF-α concentration, NIHSS score, and MOCA score between the groups.

Results

There were no significant differences in the concentrations of IL-6, IL-1β, TNF-α and NIHSS, MOCA scores between the two groups of patients before treatment (P＞0.05). After 14 days of treatment, the concentrations of IL-6, IL-1β, TNF-α in the treatment group decreased much more than that in the control group, and the difference was statistically significant. The NIHSS score of the treatment group was significantly lower than the control group [(6.29±1.72) pg/ml vs (7.78±1.97) pg/ml; (13.40±1.20) ng/L vs (18.12±1.30) ng/L; (1.28±0.35) pg/ml vs (1.43±0.32) pg/ml], and the difference was statistically significant. After 3 months, the MOCA score was higher than the control group [(26.38±1.60) vs (25.03±2.36)], and the difference was statistically significant.

Conclusion

Compared with the control group, the butylphthalide injection group reduced IL-6, IL-1β, TNF-α secretion in patients with acute cerebral infarction, thereby probably improving the prognosis of patients with acute cerebral infarction.

Key words: Cerebral infarction, Butylphthalide, Acute phase, Cytokines, Interleukin-6, Interleukin-1β, Tumor necrosis factor-α
表1 2组首次发生急性脑梗死患者的一般临床资料的比较
组别 例数 男/女（例） 年龄（岁，±s） 收缩压（mmHg，±s） 舒张压（mmHg，±s） 糖化血红蛋白（%，±s） 治疗前
NIHSS评分（分，±s） MOCA评分（分，±s）
对照组 40 23/17 63.90±10.67 130.45±11.43 78.08±4.79 5.47±0.71 13.38±3.48 27.20±1.59
治疗组 40 21/19 66.55±8.53 130.95±12.97 79.25±6.53 5.70±0.78 14.07±3.73 27.18±1.10
统计值 χ2=0.202 t=0.072 t=-0.183 t=-0.918 t=-1.354 t=-0.868 t=0.099
P值 0.653 0.223 0.855 0.361 0.180 0.388 0.922
表2 2组首次发生急性脑梗死患者临床疗效比较［例（%）］
组别 例数 无效 有效 显效 总有效
对照组 40 10（25.0） 14（35.0） 16（40.0） 30（75.0）
治疗组 40 3（7.5） 10（25.0） 27（67.5） 37（92.5）
表3 2组首次发生急性脑梗死患者治疗前后IL-6、IL-1β、TNF-α比较（±s）
组别 例数 IL-6（pg/ml） IL-1β（ng/L） TNF-α（pg/ml）
治疗前 治疗后 治疗前 治疗后 治疗前 治疗后
对照组 40 10.40±2.82 7.78±1.97 25.06±2.86 18.12±1.30 1.90±0.46 1.43±0.32
治疗组 40 11.11±3.05 6.29±1.72 25.79±2.74 13.40±1.20 1.95±0.62 1.28±0.35
t值 -1.089 3.586 -1.168 16.875 -0.405 2.002
P值 0.279 0.001 0.246 ＜0.001 0.686 0.049
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