Akut iskemik inmede serum interlökin-6 düzeylerinin lezyon büyüklüğü ve erken dönem fonksiyonel kötüleşme ile ilişkisi

Yıl 2018, Cilt: 2 Sayı: 2, 102 - 110, 02.07.2018

Aynur Yılmaz Avcı Ahmet Muzaffer Demir Ufuk Utku Adile Özden Vural Galip Ekuklu

https://doi.org/10.30565/medalanya.386697

Öz

Amaç: Bu çalışmada, akut dönemde serum İnterlökin-6 (IL-6) düzeylerinin iskemik lezyon büyüklüğü, lokalizasyonu ve hastalığın erken dönem nörolojik fonksiyonel kötüleşmesi ile ilişkisi araştırıldı. 

Hastalar ve Yöntem: Çalışmaya akut serebral infarkt tanısı alan 55 olgu alındı. Kontrol grubu, benzer yaş aralığında 25 sağlıklı gönüllüden oluşturuldu. Olgular BBT’de infarkt yeri ve büyüklüğüne göre dört gruba ayrıldı. Modifiye Rankin Skoru ile erken dönem fonksiyonel kötüleşme değerlendirildi. 

Bulgular: Serum IL-6 seviyeleri sağlıklı kontrol grubuna göre tüm hasta gruplarında anlamlı olarak daha yüksek saptandı (p=0.001). Bilgisayarlı beyin tomografisinde (BBT) büyük lezyonu olanların IL-6 düzeyleri, küçük olanlara göre anlamlı olarak daha yüksek saptandı; ancak lezyon yerleşimi açısından anlamlı farklılık yoktu. Erken dönem fonksiyonel kötüleşmesi daha fazla olan olguların IL-6 değerleri, erken dönem fonksiyonel durumları iyi olan gruba göre anlamlı olarak daha yüksekti. IL-6 düzeyleri ile lökosit sayısı ve fibrinojen düzeyleri arasında anlamlı zayıf korelasyon saptandı. 

Sonuç: Serum IL-6 düzeyi yüksekliğinin lezyon büyüklüğü ve erken dönem fonksiyonel kötüleşme ile ilişkili olması; IL-6’nın intratekal salındığını ve inme patofizyolojisinde önemli rol oynayabileceğini düşündürebilir. Ayrıca akut iskemik inme sonrası inflamatuvar yanıtın IL-6 ile değerlendirilmesi serebral infarkt boyutu ve erken dönem fonksiyonel kötüleşmesi hakkında fikir verebilir. 

Anahtar Kelimeler

Strok, sitokin, inflamasyon, vasküler hastalık, bilgisayarlı beyin tomografisi, görüntüleme

The relationship between serum interleukin-6 levels with lesion size and early functional worsening in acute ischemic stroke

Öz

Aim: In this study, the relationship between ischemic lesion size, localization and early neurological functional impairment of serum Interleukin-6 (IL-6) levels in the acute phase are investigated. 

Patients and Method: Fifty five patients who are diagnosed acute cerebral infarct by history, neurologic examination and computerized brain tomography (CT) were included in the study. The control group consisted of 25 healthy volunteers of similar age range with the patient group.The patients were subdivided into 4 groups according to the size and localization of the infarct on CT. The early neurologic functional stage was evaluated by modified Rankine Score. 

Results: Serum IL-6 levels were found significantly higher in all patients groups compared to healthy control group (p=0.001). IL-6 levels of patients with large lesions in CT were found significantly higher than that of patients with small lesions, but there were no significant difference with regard to localization of the lesion. IL-6 levels of poor early functional worsening group were found significantly higher than good functional group. There was a significant weak correlation between IL-6 levels and leukocyte count and fibrinogen levels. 

Conclusion: The elevation of serum IL-6 levels correlates with lesion size and prognosis suggesting that IL-6 is intrathecally released and may play an important role in stroke pathophysiology. Furthermore, evaluation of the inflammatory response after acute ischemic stroke with IL-6 may provide insight into the size of the cerebral infarction and deterioration with early function worsening. 

Anahtar Kelimeler

Stroke, cytokine, inflammation, vascular disease, computerized tomography, imagin

Kaynakça

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