研究白细胞介素33（IL-33）在急性缺血性脑卒中患者中的水平变化及其与脑卒中患者临床预后的关系。

选择开平市中心医院内三科及江门市人民医院神经内科自2017年1月至2019年6月收治的192例急性缺血性脑卒中患者作为研究对象，并随机选择100例健康成年人作为对照组，比较缺血性脑卒中患者在治疗前和治疗后第1、3、7天时与健康成年人外周血IL-33的变化及差异，并将脑卒中患者根据IL-33水平从低到高排序，比较IL-33低水平组（四分位数P25以下）和IL-33高水平组（四分位数P75以上）患者治疗后第3个月的改良Rankin量表（mRs）评分、日常生活能力评分（ADL）评分不良事件发生率，同时通过受试者工作特征（ROC）曲线分析IL-33对缺血性脑卒中患者临床预后的预测价值。

IL-33在急性缺血性脑卒中患者中表达水平升高，入院时平均水平（575.36±200.75）pg/mL，入院后第1天平均水平（727.13±204.96）pg/mL，入院后第3天平均水平（647.92±228.41）pg/mL，入院后第7天平均水平（639.02±185.29）pg/mL，而健康成年人平均水平为（410.32±145.58）pg/mL，差异均有统计学意义（P<0.05）；IL-33高水平组患者在mRs评分、ADL评分中不良事件发生率均高于IL-33低水平组患者，差异有统计学意义（P<0.05）；mRs评分、ADL评分标准下IL-33作为临床预后评价指标的ROC曲线下面积分别为0.847和0.727。

急性缺血性脑卒中患者外周血清中IL-33的水平显著升高，并对患者的临床预后有较好的预测价值，IL-33水平升高越显著，患者的临床预后越差。

To investigate the level of interleukin-33 (IL-33) in patients with acute ischemic stroke and its relationship with the clinical prognosis of patients with stroke.

One hundred and ninety-two cases of patients with acute ischemic stroke from Kaiping Central Hospitals and Jiangmen People’s Hospital from January 2017 to June 2019, were selected as the research object, and randomly choose 100 cases of healthy adults as control group, ischemic cerebral apoplexy patients before treatment and after treatment 1^st, 3^rd, 7^th day, and the change of IL-33 healthy adult peripheral blood, and difference, and according to the level of IL-33 patients with cerebral apoplexy from low to high, The differences in the incidence of adverse events of modified Rankin scale (mRs) score and activity of daily living (ADL) score in patients with low level IL-33 (below quartile P25) and high level IL-33 (above quartile P75) at the 3^rd month after treatment were compared. Meanwhile, the predictive value of IL-33 in clinical prognosis of patients with ischemic stroke was analyzed by receiver operating characteristic (ROC) curve.

IL-33 levels in patients with acute ischemic stroke were higher in patients with ischemic stroke, the average on admission was (575.36±200.75)pg/mL, (727.13±204.96)pg/mL at 1^st day after admission, (647.92±228.41)pg/mL at 3^rd day after admission, and (639.02±185.29)pg/mL at 7^th day after admission, while in healthy adults, the average level of IL-33 was (410.32±145.58)pg/mL, these differences between patients with ischemic stroke and healthy adults at different point were statistically significant (P<0.05). The incidence of adverse events in mRs score and ADL score of patients with high IL-33 level was higher than that of patients with low IL-33 level (P<0.05). The area under the ROC curve of IL-33 as a clinical prognostic indicator under the mRs score and ADL score were 0.847 and 0.727, respectively.

The level of IL-33 in peripheral blood of patients with acute ischemic stroke is significantly higher, and has a better predictive value for the prognosis of patients. The higher the level of IL-33 is, the worse the prognosis of patients is.