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目的探讨急性脑梗死患者血清中CD40L、IL-18与患者神经功能损伤及脑血流动力学的关系。方法分析本院2015年1月-2016年1月收治的75例急性脑梗死患者,均采用NIHSS评分评价患者神经功能缺损,采用脑血管血流动力学分析仪检测患者脑血管血流,采用ELISA法检测患者血清中CD40L、IL-18,分析CD40L、IL-18与患者神经功能损伤及脑血流动力学的关系。结果 IL-18和CD40L低水平的患者脑血流动力学指标Qmean、Vmean、DR、ZCV、R均明显优于相应的高水平组患者;IL-18和CD40L低水平患者各时间点(1 d、7 d、14 d)NHISS评分均明显低于相应高水平患者,差异均有统计学意义(P<0.05);CD40L、IL-18与患者NIHSS评分呈正相关(r值分别为0.625、0.457,P<0.05)。CD40L、IL-18、NIHSS评分是脑梗死患者死亡的独立危险因素。结论血清中CD40L、IL-18与脑梗死患者神经功能损伤及预后密切相关。
Objective To investigate the relationship between the serum levels of CD40L and IL-18 in patients with acute cerebral infarction and the neurological dysfunction and cerebral hemodynamics. Methods A total of 75 patients with acute cerebral infarction admitted to our hospital from January 2015 to January 2016 were enrolled in this study. NIHSS scores were used to evaluate neurological deficits. Cerebrovascular hemodynamic analyzer was used to detect cerebrovascular blood flow. ELISA Method to detect serum CD40L, IL-18, analysis of CD40L, IL-18 in patients with neurological impairment and cerebral hemodynamics relationship. Results Qmean, Vmean, DR, ZCV, R of patients with low IL-18 and CD40L levels were significantly better than those of the corresponding high-level patients. The levels of IL-18 and CD40L in low- , 7 d and 14 d respectively) were significantly lower than those of the corresponding high-level patients (P <0.05). There was a positive correlation between CD40L, IL-18 and NIHSS score (r = 0.625,0.457, P <0.05). CD40L, IL-18, NIHSS score is an independent risk factor for death in patients with cerebral infarction. Conclusion Serum CD40L and IL-18 are closely related to the neurological impairment and prognosis in patients with cerebral infarction.