Abstract:

Objective To investigate the changes of peripheral blood cortisol, interferon-γ (IFN-γ), interleukin-4 (IL-4) and interleukin-10 (IL-10) levels in patients with stroke-associated infection(SAI). Methods Eighty-five patients with acute cerebral infarction or cerebral hemorrhage admitted to hospital within 24 h after symptom onset were selected. Patients were divided into infection group (n=29) and non-infection group (n=56) according to the infection status within 7 d after admission. Serum cortisol levels were measured by chemiluminescence method, and plasma IFN-γ, IL-4 and IL-10 levels were determined by ELISA on the first day and seventh day after admission. Stepwise Logistic regression analysis was adopted to explore the correlation factors for SAI. Results On the first day and seventh day after admission, the levels of serum cortisol and plasma IL-4 and IL-10 in infection group were significantly higher than those in non-infection group (P<0.05), while the level of plasma IFN-γ in infection group was significantly lower than that in non-infection group (P<0.05). On the first day after admission, the correlation analysis indicated that there was a negative correlation between level of serum cortisol and level of plasma IFN-γ （r=-0.299，P=0.024）, and there was a positive correlation between level of serum cortisol and levels of plasma IL-4 and IL-10 （r=0.298，P=0.040；r=0.306，P=0.026）. Logistic regression analysis revealed that increased level of serum cortisol on the first day after admission was an independent risk factor for SAI （OR, 0.903; 95% confidence interval, 0.816-1.000; P=0.05）. Conclusion Cortisol, IFN-γ, IL-4 and IL-10 may play important roles in the development of SAI.

Key words: stroke-associated infection, cortisol, IFN-γ, IL-4, IL-10, Th1/Th2