血清细胞因子与脑卒中后失眠的相关性研究

目的 探讨血清细胞因子与脑卒中后失眠的相关性。方法 选取我院2014年11月—2015年12月收治的70例脑卒中后失眠且中医辨证为心脾两虚型患者（观察组），同时选取同期脑卒中后非失眠患者70例（对照组）。比较两组患者血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-1β（IL-1β）水平，并比较不同程度失眠患者血清TNF-α、IL-6、IL-1β水平。结果 观察组PSQI总评分（13.10±3.45）显著高于对照组的（4.23±2.35）（t=17.90，P<0.05）。观察组患者IL-6、IL-1β水平均显著高于对照组，TNF-α显著低于对照组，差异具有统计学意义（t=38.56，13.61，14.35，均P<0.05）。不同程度睡眠障碍患者TNF-α、IL-6、IL-1β水平比较，差异具有统计学意义（F=8.47，10.36，11.27，均P<0.05），且随着睡眠障碍程度的增加，IL-6、IL-1β水平呈上升趋势，TNF-α水平呈下降的趋势。进一步相关性分析结果显示睡眠障碍程度与血清TNF-α水平呈负相关，r=-1.856（P<0.05）；IL-6、IL-1β水平呈正相关，r=0.720，0.745（均P<0.05）。结论 细胞因子TNF-α、IL-6、IL-1β与卒中后失眠有显著相关性，在临床工作中对有上述血清细胞因子异常的脑卒中患者给予必要的干预有重要的临床意义。

Correlation between serum cytokines and insomnia after stroke

Objective To discuss the correlation between serum cytokines and stroke-related insomnia．Methods Seventy patients with insomnia after stroke who were treated in our hospital and diagnosed as deficiency of both heart and spleen by using traditional Chinese medicine（TCM）method were selected as the observation group，with 70 patients with no insomnia after stroke as the control group．The levels of TNF-α，IL-6 and IL-1β were compared between the two groups，as well as among patients with different severity of insomnia．Results The overall PSQI score of the observation group（13.10±3.45）was significantly higher than that of the control group（4.23±2.35）（t=17.90，P<0.05）．The levels of IL-6 and IL-1β were significantly higher while that of TNF-α significantly lower in the observation group than in the control group，respectively（t=38.56，13.61，14.35，P<0.05）．There were significant differences in the levels of TNF-α，IL-6 and IL-1β among patients with different degrees of insomnia（F=8.47，10.36，11.27，P<0.05）．The levels of IL-6 and IL-1β showed upward trend while that of TNF-α decreased along with the increasing of the severity of insomnia．Further analysis showed a significant negative correlation between TNF-α level and insomnia after stroke（r=-1.856，P<0.05）；the levels of IL-6 and IL-1β were positively correlated with insomnia after stroke（r=0.720，0.745）（P<0.05）．Conclusion The cytokines TNF-α，IL-6 and IL-1β are significantly correlated with insomnia after stroke．It is of important clinical significance to give necessary intervention to stroke patients with abnormal levels of above-mentioned serum cytokines in clinical practice．