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Abstract
Aim. To study the relationship between the dynamics of serum concentrations of interleukin-1β, interleukin-6 and interleukin-10 with clinical data in the acute period of ischemic stroke, and the strategy of reperfusion therapy.Materials and methods. In 28 patients with acute ischemic stroke, half of whom underwent intravenous thrombolysis, the concentration of interleukin-1β, interleukin-6 and interleukin-10 was assessed at admission, on the 3rd and 10th day of the disease.Results. The concentration of interleukin-1β and interleukin-6 decreases during the acute period of stroke. The concentration of interleukin-10 remains unchanged for the first 10 days since the development of stroke. When thrombolysis is performed, there is a more significant decrease in interleukin-1β concentration in the hyperacute period of stroke, whereas in patients without reperfusion there is a decrease in interleukin-6 concentration from 1 to 10 days. The concentration of cytokines is associated with age, lipid spectrum, severity of carotid atherosclerosis, myocardial hypertrophy and injection fraction of the heart. Only in the subgroup of thrombolysis, correlations of cytokine concentrations with systolic blood pressure at admission, hemoglobin concentration, total cholesterol and high-density lipoproteins, hematocrit, degree of stenosis of the contralateral carotid artery, injection fraction and the number of antihypertensive drugs prescribed in the hospital were recorded. The concentration of interleukin-6 at day 10 is associated with the severity of stroke at admission, and the level of IL-10 on day 3 of the disease, with the mobility of patients at discharge.Conclusions. In the hyperacute period of stroke, there is a decrease in the pro-inflammatory activity of blood serum, more pronounced in patients undergoing systemic thrombolysis. Concentrations of interleukin1β, interleukin-6 and interleukin-10 are associated with a wide range of parameters characterizing the cardiovascular and functional status, and the pattern of these associations differs depending on the reperfusion therapy strategy.
Highlights
The concentration of interleukin-1β and interleukin-6 decreases during the acute period of stroke
In the subgroup of thrombolysis, correlations of cytokine concentrations with systolic blood pressure at admission, hemoglobin concentration, total cholesterol and high-density lipoproteins, hematocrit, degree of stenosis of the contralateral carotid artery, injection fraction and the number of antihypertensive drugs prescribed in the hospital were recorded
The concentration of interleukin-6 at day 10 is associated with the severity of stroke at admission, and the level of IL-10 on day 3 of the disease, with the mobility of patients at discharge
Summary
Èçó÷èòü âçàèìîñâÿçü äèíàìèêè ñûâîðîòî÷íûõ êîíöåíòðàöèé èíòåðëåéêèíà-1β, èíòåðëåéêèíà-6 è èíòåðëåéêèíà-10 ñ êëèíè÷åñêèìè äàííûìè â îñòðîì ïåðèîäå èøåìè÷åñêîãî èíñóëüòà â çàâèñèìîñòè îò ñòðàòåãèè ðåïåðôóçèîííîé òåðàïèè. Ó âñåõ ïàöèåíòîâ â îñòðîì ïåðèîäå èøåìè÷åñêîãî èíñóëüòà, 14 èç êîòîðûõ ïðîâîäèëàñü âíóòðèâåííàÿ òðîìáîëèòè÷åñêàÿ òåðàïèÿ, îöåíåíà êîíöåíòðàöèÿ èíòåðëåéêèíà-1β, èíòåðëåéêèíà-6 è èíòåðëåéêèíà-10 ïðè ïîñòóïëåíèè, íà 3-è è 10-å ñóò çàáîëåâàíèÿ. Ïðè ïðîâåäåíèè òðîìáîëèçèñà îòìå÷àåòñÿ áîëåå çíà÷èìîå ñíèæåíèå êîíöåíòðàöèè èíòåðëåéêèíà-1β â îñòðåéøåì ïåðèîäå èíñóëüòà, òîãäà êàê ó ïàöèåíòîâ áåç ðåïåðôóçèè íàáëþäàåòñÿ ñíèæåíèå êîíöåíòðàöèè èíòåðëåéêèíà-6 ñ 1-ãî ïî 10-å ñóò çàáîëåâàíèÿ. Êîíöåíòðàöèÿ èíòåðëåéêèíà-6 íà 10-å ñóò ñâÿçàíà ñ òÿæåñòüþ èíñóëüòà ïðè ïîñòóïëåíèè â ñòàöèîíàð, à óðîâåíü èíòåðëåéêèíà-10 íà 3-è ñóò çàáîëåâàíèÿ − ñ ìîáèëüíîñòüþ ïàöèåíòîâ ïðè âûïèñêå.  îñòðåéøåì ïåðèîäå èíñóëüòà ïðîèñõîäèò ñíèæåíèå ïðîâîñïàëèòåëüíîé àêòèâíîñòè ñûâîðîòêè êðîâè, áîëåå âûðàæåííîå ó ïàöèåíòîâ, êîòîðûì ïðîâåäåí ñèñòåìíûé òðîìáîëèçèñ.
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