脳梗塞急性期における炎症マーカーの測定―予後および経過の指標としての検討―

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タイトル別名
  • Inflammatory markers observed in the acute phase of ischemic stroke: a possible indicator of severity and prognosis
  • a possible indicator of severity and prognosis
  • 予後および経過の指標としての検討

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Inflammation of the vascular endothelium is reported to cause atheromatous plaques and worsened athe-rosclerosis. It has been found that stroke patients with atherosclerotic lesions present increased inflammatory markers in the chronic stage. Focal inflammation following ischemia causes expansion of the stroke volume, and even oxidative stress plays an important role in the pathogenesis of vascular injury. It is critical therefore to minimize the effects of inflammation in order to improve the treatment and outcome of stroke patients. Ischemic stroke patients who were admitted to hospital within 24 hr of the onset were enrolled into the present study (n=104). The subjects were classified into the following groups based on their MRI and MRA findings : embolic stroke (n=30), atheromatous stroke (n=29), lacunar stroke (n=41), and arterial dissection (n=4). Inflammatory markers, such as high-sensitive CRP (hsCRP), TNFgbα, IL-6 and oxidized LDL, were sampled on admission. The NIHSS was used for assessment of the clinical severity, which was observed on the first and 28th days from the onset. The oxidized LDL was significantly elevated in all groups on admission. The hsCRP was significantly elevated in the embolic and atheromatous stroke groups. A significant correlation with the NIHSS was noted for the IL-6 of the embolic stroke group and for the TNFα of the lacunar stroke group. A deteriorating outcome was related to an increased level of IL-6 in the embolic stroke group. In conclusion, increases of inflammatory markers, observed in the acute phase, may indicate the severity of stroke lesions.

収録刊行物

  • 脳卒中

    脳卒中 28 (3), 360-366, 2006

    一般社団法人 日本脳卒中学会

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