Abstract
Objective To investigate the relationship between serum anticardiolipin antibody-immune globulin G (ACA-IgG),interleukin-10 (IL-10 ),IL-17 levels and intracranial large-artery atherosclerotic stenosis in patients with ischemic stroke. Methods From March 2014 to March 2015,a total of 176 consecutive patients with the first-ever ischemic stroke admitted to the Department of Neurology,Liaocheng People′s Hospital,Shandong Province,China,and performed DSA were enrolled prospectively. Seven of the patients with cardiogenic embolism,5 with moyamoya disease,8 with arteritis,2 with artery dissection,9 with autoimmune diseases or acute and chronic inflammation were excluded,21 with extracranial arterial stenosis were not enrolled,and finally 124 were enrolled in the study. According to the findings of DSA,the degrees of intracranial large artery stenosis were divided into a stenosis-free group (n = 34),a mild-stenosis group (n = 30),a moderate-stenosis group (n = 32),and a severe-stenosis group (n = 28). The differences of serum ACA-IgG,IL-10,IL-17 levels and baseline factors of the 4 groups were compared,and multivariate logistic regression analysis was used to analyze several factors that affected intracranial large-artery stenosis. Results There were no significant differences in sex,age,alcohol consumption rate,smoking rate,and incidence of hyperlipidemia among the 4 groups of patients (all P >0. 05). Compared with the stenosis-free group,there were significant differences in the incidences of hypertension and diabetes among the mild-stenosis,moderate-stenosis and severe-stenosis groups (the incidence of hypertension,80. 0% [n = 24],93. 8% [n = 30],89. 3% [n = 25]vs. 55. 9% [19 cases];χ2 = 8. 271,8. 920,and 10. 877,respectively;P = 0. 038,0. 032,and 0. 014,respectively). The incidences of diabetes were 33. 3% (n = 10),43. 8% (n = 14),60. 7% (n = 17)vs. 8. 8% (n = 3),(χ2 = 7. 960, 8. 733,and 9. 285,respectively;P = 0. 043,0. 035,and 0. 027,respectively). Incidence of diabetes of the severe-stenosis group was higher than that of the mild-stenosis group (χ2 = 9. 348,P = 0. 025). There were no significant differences in the incidences of hypertension and diabetes among other groups (all P >0. 05). There were significant differences in ACA-IgG levels (23 ± 5,39 ± 8,51 ± 9,and 65 ± 10 kU/ L);IL-10 levels (108 ± 33,85 ± 25,77 ± 21,and 62 ± 19 ng/ L),and IL-17 levels (38 ± 10,58 ± 22,63 ± 31, and 75 ± 26 ng/ L)among the stenosis-free,mild,moderate and severe-stenosis groups (F = 17. 754,9. 827, and 12. 656;respectively;all P < 0. 01). Compared with the stenosis-free group,the ACA-IgG and IL-17 levels of the patients in the mild,morderate,and severe stenosis groups increased significantly (ACA-IgG level:t =2. 307,2. 559,and 3. 374,respectively;P = 0. 026,0. 014,and 0. 001,respectively,the IL-17 levels:t =2. 183,2. 549 and 3. 159,respectively;P = 0. 037,0. 013,and 0. 002,respectively),while the IL-10 level decreased significantly. There were significant differences among the groups (t = 2. 036,2. 351,and 2. 762, respectively;P = 0. 042,0. 023,and 0. 006,respectively). Compared with the mild-stenosis group,the ACA-IgG and IL-17 levels of the severe stenosis group increased significantly (t = 3. 154 and 2. 976 respectively;P = 0. 002 and 0. 004 respectively). There were no significant differences among the pairwise comparisons of other groups (P >0. 05). The results of logistic regression analysis showed that hypertension, diabetes,ACA-IgG level,and IL-17 level were the risk factors for intracranial large-artery stenosis (OR, 3. 043,95% CI 1. 606 -5. 875,P = 0. 003;OR,2. 912,95% CI 1. 513 -5. 824,P < 0. 01;OR,1. 837,95% CI 2. 057-3. 416,P = 0. 037;OR,1. 453,95% CI 1. 346 -2. 721,P = 0. 014). Conclusion ACA-IgG and IL-17 may play an important role in the occurrence and development processes of intracranial large-artery atherosclerotic stenosis.关键词
卒中/颅内动脉狭窄/抗心磷脂抗体/白细胞介素10/白细胞介素17Key words
Stroke/Intracerebral artery stenosis/Anticardiolipin antibody/Interleukin-10/Interleukin-17
