血清TNF-α、IL-6、CRP水平对老年急性脑梗死患者介入治疗后睡眠障碍的预测价值-东南大学学报医学版

血清TNF-α、IL-6、CRP水平对老年急性脑梗死患者介入治疗后睡眠障碍的预测价值

单位：1. 河南科技大学第一附属医院神经内科, 河南洛阳 471003;
2. 河南科技大学第一附属医院全科医学科, 河南洛阳 471003

关键词：急性脑梗死介入治疗睡眠障碍肿瘤坏死因子-α 白细胞介素-6 C反应蛋白预测

分类号：R749.13

出版年·卷·期（页码）：2021·40·第六期（760-765）

摘要：

目的: 探讨血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)水平对老年急性脑梗死(ACI)患者介入治疗后睡眠障碍发生风险的预测价值。方法: 收集本院2017年4月至2020年8月接受介入治疗且完成6个月随访的137例老年ACI患者的临床资料, 患者均接受血清TNF-α、IL-6、CRP水平检测。统计患者睡眠障碍情况并分组, 分析血清TNF-α、IL-6、CRP水平与老年ACI患者介入治疗后发生睡眠障碍的关系。结果: 137例老年ACI患者介入治疗后有51例发生睡眠障碍, 占37.23%;睡眠障碍组TNF-α、IL-6、CRP水平均高于睡眠良好组(P < 0.05); Logistic回归分析显示, 血清TNF-α、IL-6、CRP过表达可能是老年ACI患者介入治疗后发生睡眠障碍的风险因子(OR > 1, P < 0.05);绘制ROC曲线发现, 血清TNF-α、IL-6、CRP单一及联合预测老年ACI患者介入治疗后发生睡眠障碍风险的AUC均 > 0.80, 均有一定预测价值; Spearman相关分析显示, TNF-α、IL-6、CRP三者水平均呈正相关(r > 0, P < 0.05)。结论: 血清TNF-α、IL-6、CRP过表达与老年ACI患者介入治疗后发生睡眠障碍有关。

Objective: To analyze the value of serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP) levels in predicting the risk of sleep disorder in elderly patients with acute cerebral infarction (ACI) after interventional therapy.Methods: The clinical data of 137 elderly ACI patients who received interventional treatment and completed 6 months of follow-up from April 2017 to August 2020 in our hospital were collected, serum TNF-α, IL-6 and CRP levels were detected. The sleep disorder patients were counted and grouped, the relationship between serum TNF-α, IL-6 and CRP levels and sleep disorders after interventional therapy in elderly ACI patients was analyzed.Results: In 137 elderly patients with ACI after interventional therapy, 51 patients had sleep disorder, accounting for 37.23%; the levels of serum TNF-α, IL-6 and CRP in sleep disorder group were higher than those in the sleep well group (P < 0.05); Logistic regression analysis showed that the overexpression of serum TNF-α, IL-6 and CRP alone and in combination in the elderly patients with ACI might be the risk factors of sleep disorder after interventional therapy (OR > 1, P < 0.05); the ROC curve was drawn, the AUC of serum TNF-α, IL-6, CRP alone and in combination in predicting the risk of sleep disorder in the elderly patients with ACI after interventional therapy were all >0.80, all had certain predictive value; Spearman correlation test showed that the levels of TNF-α, IL-6 and CRP were positively correlated(r > 0, P < 0.05).Conclusion: The overexpression of serum TNF-α, IL-6 and CRP in the elderly patients with ACI is related to sleep disorder after interventional therapy.

参考文献：

[1] ZHANG T, XIANG L. Elevated plasma haptoglobin level as a potential marker for poor prognosis in acute cerebral infarction[J]. Eur Neurol, 2018, 79(3-4): 154-160.
[2] 张锋岂, 张如坚, 林加潞, 等. 血清MMP-9、VEGF、D-D在急性脑梗死介入治疗前后的变化及与凝血功能和预后的关系[J]. 脑与神经疾病杂志, 2020, 28(2): 105-109.
[3] 高微, 薛蓉, 周凯丽. 脑卒中并发睡眠障碍研究进展[J]. 国际神经病学神经外科学杂志, 2018, 45(5): 101-105.
[4] 祝善尧, 葛伟, 张欢, 等. 老年急性缺血性脑卒中后抑郁患者睡眠障碍现状及与血清IL-1、IL-2、5-HT和Hypocretin的相关性[J]. 中国老年学杂志, 2020, 40(3): 33-38.
[5] 韩大明, 杨军, 王著敏, 等. 卒中相关睡眠障碍与卒中位置和炎性因子的关系[J]. 国际精神病学杂志, 2019, 46(3): 138-140.
[6] BILGIN I A, HATIPOGLU E, AGHAYEVA A, et al. Predicting value of serum procalcitonin, C-reactive protein, drain fluid culture, drain fluid interleukin-6, and tumor necrosis factor-α levels in anastomotic leakage after rectal resection[J]. Surg Infect(Larchmt), 2017, 18(3): 350-356.
[7] GÖRTLER M, OLDAG A, BREJOVA A, et al. Ischemic stroke-diagnosis and treatment[J]. Anasthesiol Intensivmed Notfallmed Schmerzther, 2014, 49(6): 388-394.
[8] BERTOLAZI A N, FAGONDES S C, HOFF L S, et al. Validation of the brazilian portuguese version of the pittsburgh sleep quality index[J]. Sleep Med, 2011, 12(1): 70-75.
[9] NAESS H, KURTZ M, THOMASSEN L, et al. Serial NIHSS scores in patients with acute cerebral infarction[J]. Acta Neurol Scand, 2016, 133(6): 415-420.
[10] 李双英, 张赛, 李平. 急性脑卒中后睡眠障碍相关因素分析[J]. 武警后勤学院学报(医学版), 2017, 26(7): 35-37.
[11] PARASRAM M, SEGAL A Z. Sleep disorders and stroke: does treatment of bbstructive sleep apnea decrease risk of ischemic stroke? [J]. Curr Treat Options Neurol, 2019, 21(7): 29.
[12] 张颖. 急性脑梗死患者急性期血清OPN、氧化应激水平的变化及其与神经损伤和预后的关系[J]. 广东医学, 2017, 38(9): 1386-1389.
[13] YU H, WANG X, KANG F, et al. Propofol attenuates inflammatory damage on neurons following cerebral infarction by inhibiting excessive activation of microglia[J]. Int J Mol Med, 2019, 43(1): 452-460.
[14] 范磊, 岳秉宏, 刘星亮, 等. 血清胎球蛋白A、肿瘤坏死因子-α和白介素-1β联合诊断急性脑梗死患者颈动脉易损斑块的价值[J]. 实用医学杂志, 2019, 35(3): 350-355.
[15] 郭鹏, 任凯夕, 沈金金. 脑梗死患者血清miR-497、TNF-α表达水平变化及其临床意义[J]. 卒中与神经疾病, 2020, 27(6): 62-65, 70.
[16] 唐国富, 李志远, 马可, 等. 急性脑梗死患者血清let-7f、IL-6的水平变化及意义[J]. 山东医药, 2019, 59(28): 73-76.
[17] CHEN J, ZHANG W, WU Y Q, et al. Correlations of acute myocardial infarction complicated by cerebral infarction with insulin resistance, adiponectin and HMGB1[J]. Eur Rev Med Pharmacol Sci, 2019, 23(10): 4425-4431.
[18] RAJAB M, JUMAA M, HORANIAH M Y, et al. Correlations of C-reactive protein and folate with smoking, sport, hematological inflammation biomarkers and anthropometrics in syrian university female students cross-sectional study[J]. Sci Rep, 2019, 9(1): 15189.
[19] 刘琦, 陈雄辉, 杨志勇. 老年急性脑梗死认知功能障碍的特点及其与血浆pro-BNP和CRP的相关性[J]. 中国老年学杂志, 2019, 39(10): 2330-2332.
[20] 赵惠卿, 吴冬雨, 朱宪策, 等. 脑梗死患者睡眠质量与梗死部位及神经功能缺损程度的关联探究[J]. 解放军预防医学杂志, 2019, 37(8): 7-9, 16.
[21] 直建光, 胡建荣, 李鹏飞, 等. 急性脑梗死后睡眠障碍与卒中位置和炎性因子的相关性[J]. 国际精神病学杂志, 2019, 46(4): 690-692, 699.

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