【摘要】 目的 探讨白介素6(IL-6)、白介素10(IL-10)、C-反应蛋白(CRP)及肿瘤坏死因子(TNF-α)的表达水平与脑小血管病(CSVD)患者病程进展的相关性，以期为临床评估病情、制订干预方案提供参考。方法 选取聊城市第三人民医院2021年1月至2022年1月就诊的60例CSVD患者为研究对象，随访1年，根据随访结果将患者分为进展组(39例)和无进展组(21例)，比较两组及不同病变程度患者临床资料、入院时血清IL-6、IL-10、CRP、TNF-α水平，分析入院时血清IL-6、IL-10、CRP、TNF-α水平与临床资料、CSVD严重程度及CSVD病程进展相关性，并分析其水平变化对CSVD病程进展的预测价值。结果 进展组入院时血清IL-6、CRP、TNF-α水平高于无进展组，IL-10水平、简易智力状态检查量表(MMSE)评分低于无进展组，差异有统计学意义(P<0.05)。重度患者的IL-6、CRP、TNF-α水平高于轻度、中度患者，差异有统计学意义(P<0.05)，重度患者的IL-10水平低于轻度、中度患者，差异有统计学意义(P<0.05)。入院时血清IL-6、CRP、TNF-α水平与MMSE评分呈负相关，与CSVD严重程度、CSVD病程进展呈正相关(P<0.05)。血清IL-10水平与MMSE评分呈正相关，与CSVD严重程度、CSVD病程进展呈负相关(P<0.05)；入院时血清IL-6、IL-10、CRP、TNF-α水平联合预测CSVD病程进展的AUC为0.785，最佳敏感度、特异度分别为94.87%、61.90%。结论 血清IL-6、CRP、IL-10、TNF-α水平变化可用于CSVD病情程度及病程进展评估中，为临床早期预测病程进展提供依据，以针对性制订干预方案，改善预后。更多还原

【Abstract】 Objective To explore the correlation between the expression levels of interleukin 6(IL-6), interleukin 10(IL-10), C-reactive protein(CRP) and tumor necrosis factor-α(TNF-α) and the progression of patients with cerebral small vessel disease(CSVD) is expected to provide a reference for clinical evaluation of the disease and formulation of intervention plans. Methods A total of 60 patients with CSVD who were treated in Liaocheng Third People’s Hospital from January 2021to January 2022(all completed the follow-up) were selected as the study subjects. They were followed up for 1 year.According to the follow-up results, the patients were divided into progressive group(39 cases) and non-progressive group(21 cases). The clinical data, and serum IL-6, IL-10, CRP, TNF-α at admission between two groups and patients with different degrees of lesion were compared, the correlation between the levels of serum IL-6, IL-10, CRP and TNF-α at admission the clinical datas, severity of CSVD and progression of CSVD were analyzed, and the predictive value of their levels change on progression of CSVD were analyzed. Results In the progression group at admission, the levels of serum IL-6, CRP, TNF-α were higher than those of the non progression group, while the IL-10 level and mini-mental state examination(MMSE) score were lower than those of the non progression group, with statistically significant differences(P<0.05). The levels of IL-6, CRP, TNF-α in severe patients were higher than that of mild and moderate patients, and the IL-10 levels of severe patients were lower than those of mild and moderate patients, with statistically significant differences(P<0.05). At admission, the levels of serum IL-6, CRP, TNF-α were negatively correlated with MMSE score, and positively correlated with the severity of CSVD and the progression of CSVD(P <0.05). The levels of serum IL-10 were positively correlated with MMSE score, and negatively correlated with the severity and progression of CSVD(P<0.05). The AUC of the joint the levels of serum IL-6,IL-10, CRP, TNF-α at admission for predicting the progression of CSVD was 0.785, the best sensitivity and specificity were 94.87% and 61.90%. Conclusion The levels change of serum IL-6, CRP, IL-10, TNF-α can be used in the evaluation of the degree of CSVD and the progress of the disease, providing the basis for clinical early prediction of the progress of the disease, so as to formulate targeted intervention programs and improve the prognosis.更多还原