【摘要】 目的 探讨颅内动脉血炎症因子表达水平与急性缺血性卒中取栓患者预后的相关性。方法 选择102例前循环大血管闭塞并成功接受血管内机械取栓治疗的急性缺血性卒中患者，抽取颅内动脉血栓闭塞远端的动脉血和外周血管股动脉血，检测炎症因子白介素IL-5、IL-6、IL-7、趋化因子CCL17的表达水平，同时收集各种临床资料。结果 颅内动脉血中IL-6水平明显高于外周动脉血(t=14.379,P<0.001),IL-7水平明显低于外周动脉血(t=-38.948,P<0.001);颅内、外周动脉血中IL-5、CCL17水平差异无统计学意义(均P>0.05)。Spearman秩相关分析发现，颅内血IL-6水平与取栓术后3个月的改良版Rankin量表(mRS)评分呈正相关[r=0.43, 95%CI(0.22,0.63),P≤0.001],而颅内IL-7水平与术后3个月mRS评分的相关性无统计学意义[r=-0.12,95%CI(-0.42,0.08),P=0.225]。预后良好组(mRS评分0～2分)颅内IL-6水平明显低于预后不良组(mRS评分3～6分)(t=-2.84,P=0.005)。颅内IL-6水平与取栓术后24 h脑梗死体积呈正相关[r=0.32,95%CI(0.22,0.56),P=0.001]。结论 急性大血管闭塞脑卒中患者颅内动脉血存在IL-6等炎症因子，不利于取栓患者的良好预后。更多还原

【Abstract】 Objective To explore the correlation between the expression levels of inflammatory factors in intracranial arterial blood and the prognosis of patients undergoing thrombectomy for acute ischemic stroke.Methods A total of 102 patients with acute ischemic stroke who had anterior circulation large vessel occlusion and successfully underwent endovascular mechanical thrombectomy were selected.Arterial blood distal to the intracranial artery thrombosis occlusion and peripheral femoral artery blood were drawn to detect the expression levels of inflammatory factors interleukins IL-5, IL-6, IL-7 and chemoattractant cytokine ligand CCL17, and various clinical data were collected.Results The level of IL-6 in intracranial arterial blood was significantly higher than that in peripheral arterial blood(t=14.379, P<0.001), and the level of IL-7 was significantly lower than that in peripheral arterial blood(t=-38.948, P<0.001).There was no statistically significant difference in the levels of IL-5 and CCL17 between intracranial and extracranial arterial blood(all P>0.05).Spearman rank correlation analysis showed that the intracranial blood IL-6 level was positively correlated with the modified Rankin scale(mRS) score 3 months after thrombectomy [r=0.43,95%CI(0.22,0.63), P<0.001], while the intracranial IL-7 level was not significantly correlated with the mRS score 3 months after surgery [r=-0.12,95%CI(-0.42,0.08), P=0.225].The intracranial IL-6 level in the good prognosis group(mRS 0-2 points) was significantly lower than that in the poor prognosis group(mRS 3-6 points)(t=-2.84, P=0.005).The intracranial IL-6 level was positively correlated with the cerebral infarction volume 24 hours after thrombectomy [r=0.32,95%CI(0.22,0.56), P=0.001].Conclusion The presence of inflammatory factors such as IL-6 in the intracranial arterial blood of patients with acute large vessel occlusion stroke is not conducive to a good prognosis for patients undergoing thrombectomy.更多还原