北京中医药大学学报2025，Vol.48Issue(1)：98-107,10.DOI:10.3969/j.issn.1006-2157.2025.01.012
急性缺血性中风超急性期炎性指标与早期神经功能恶化、证候要素及预后的相关性研究
Study on the correlation between inflammatory indicators in the hyperacute phase of acute ischemic stroke and early neurological deterioration,syndrome factors,and prognosis
摘要
Abstract
Objective Inflammatory cascade reactions play a crucial role in secondary neuronal injury in acute ischemic stroke(AIS).The aim of this study was to explore the correlations between specific serological indicators,early neurological deterioration(END),disease prognosis,and syndrome factors in AIS based on this injury mechanism.Methods The data for this study were collected from 135 patients with AIS admitted to the emergency department of Fangshan Hospital,Beijing University of Chinese Medicine,within 24 h of onset between November 2019 and May 2021.Among these,29 patients had complete data and experienced END.Additionally,9 non-END patients were matched from the remaining 90 patients with complete data,resulting in a total of 38 patients for statistical analysis.Statistical methods,including logistic regression and receiver operating curves,were used to analyze the correlation between serum levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-10(IL-10),vascular endothelial growth factor(VEGF),and intercellular adhesion molecule-1(ICAM-1)within 24 h of END onset,disease prognosis,and syndrome factors.Grouping criteria included END occurrence,presence of syndrome elements on the first and third day post-onset,and prognosis at 90 days post-onset.Results All 38 cases had onset time of less than 12 h,and there were no significant differences in age,gender,and onset time between the END and non-END groups.The TNF-α serum level within 24 h of onset was not associated with the occurrence of END but was negatively correlated with all-cause mortality at 90 days[0.1<odds ratio(OR)<0.3].When the TNF-α serum level exceeded 2.475 μg/L,a significant negative correlation was observed with the presence of initial blood stasis(OR<0.1;P<0.05).An elevated IL-6 serum level within 24 h of onset was negatively correlated with all-cause mortality at 90 days(0.1<OR<0.3).When the IL-6 serum level exceeded 1.295 μg/L,the risk of developing qi deficiency on the third day of onset was 18.874 times higher than that in patients with serum levels less than 1.295 μg/L(OR>10;P<0.05).An elevated IL-10 serum level within 24 h of onset showed a strong negative correlation with non-disabling and good functional outcomes at 90 days post-onset(0.1<OR<0.3).Good functional outcomes were significant(P<0.05).The IL-10 serum level was strongly negatively correlated with the presence of initial blood stasis(OR<0.1;P<0.05).When the VEGF serum level within 24 h of onset exceeded 63.710 μg/L,a strong negative correlation was observed with END susceptibility(0.1<OR<0.3).However,it was negatively correlated with all-cause mortality at 90 days(OR<1).When the VEGF serum level exceeded 136.655 μg/L,it was strongly negatively correlated with phlegm-dampness susceptibility on the third day of onset(OR<0.1;P<0.05).The ICAM-1 serum level within 24 h of onset was negatively correlated with non-disabling outcomes at 90 days post-onset(OR<1).When the ICAM-1 serum level exceeded 277 224.000 μg/L,it was strongly negatively correlated with initial blood stasis(OR<0.1).When the ICAM-1 serum level exceeded 411 238.500 μg/L,it was strongly positively correlated with initial yin deficiency(OR>10;P<0.05).When the ICAM-1 serum levels exceeded 233 599.500 μg/L and 125 141.500 μg/L,respectively,the susceptibility to endogenous wind and endogenous fire on the third day of onset was 15.364 times and 6.071 times higher,respectively,than that in patients with serum levels below these thresholds.Conclusion As accessible and objective biomarkers,inflammatory serum indicators are closely associated with both disease progression and traditional Chinese medicine(TCM)syndrome elements.They enhance AIS diagnosis,assessment,and treatment and contribute to a deeper understanding of the role of TCM syndrome differentiation in AIS diagnosis and treatment.关键词
急性缺血性中风/证候/早期神经功能恶化/超急性期/白细胞介素/肿瘤坏死因子-α/血管生长因子/细胞间黏附因子1Key words
acute ischemic stroke/traditional Chinese medicine syndromes/early neurological deterioration/hyperacute phase/interleukin/tumor necrosis factor-α/vascular endothelial growth factor/intercellular adhesion molecule-1分类
医药卫生引用本文复制引用
康利高阁,高颖,白金月,唐欢,沈红波,刘蕾,孔令博..急性缺血性中风超急性期炎性指标与早期神经功能恶化、证候要素及预后的相关性研究[J].北京中医药大学学报,2025,48(1):98-107,10.基金项目
北京市中医药科技发展资金项目(No.BJZYQN-2023-30) （No.BJZYQN-2023-30）
首都卫生发展科研专项(No.2018-1-4191) Beijing Traditional Chinese Medicine Science and Technology Development Fund(No.BJZYQN-2023-30) （No.2018-1-4191）
