脑出血患者血清TNF-α和IL-6水平与水肿体积和神经功能的关系

The relationship between serum TNF-α and IL-6 levels in patients with cerebral hemorrhage,edema volume and neurological function

目的探究脑出血患者血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平与水肿体积和患者神经功能的关系。方法选取2018年1月-2021年1月宝鸡市中心医院收治的60例脑出血患者作为研究组,另选取同期于本院体检正常的健康人30名作为对照组,患者入院时、入院3 d和入院7 d分别定义为T0、T1和T2,按照血清中TNF-α中位数和IL-6中位数分为高表达组和低表达组。采用酶联免疫吸附法(ELISA)检测血清TNF-α、IL-6水平,采用头颅CT联合多田公式计算患者脑水肿体积,采用美国国立卫生研究院卒中量表(NIHSS)评分、巴氏量表(Barthel)评分评价患者神经功能。结果研究组患者合并高血压和糖尿病的人数明显多于对照组,差异有统计学意义(χ^(2)=19.941、7.751,P均<0.05);研究组患者血清TNF-α、IL-6水平较对照组相比明显升高,差异有统计学意义(t=14.728、22.429,P均<0.05);T0、T1、T2时间点血清TNF-α、IL-6低表达组脑水肿体积均小于高表达组,差异有统计学意义(P<0.05);T1、T2时间点血清TNF-α、IL-6低表达组NIHSS评分均低于高表达组,而Barthel评分均高于高表达组,差异有统计学意义(P<0.05)。结论脑出血患者血清TNF-α、IL-6水平均升高,且与患者脑水肿体积和神经功能相关,可能作为反映脑出血患者病情和预测患者预后的相关指标发挥作用。

Objective To explore the relationship between serum tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels in patients with cerebral hemorrhage,edema volume and patients’neurological function.Methods Sixty patients with cerebral hemorrhage admitted to Baoji Central Hospital from January 2018 to January 2021 were selected as the research group,and 30 healthy people who had no abnormalities in the physical examination of the hospital during the same period were selected as the control group.The time of patients admitted,3 days after admission,and 7 days after admission were defined as T0,T1 and T2.Patients were divided into high expression group and low expression group according to the levels of serum TNF-αand IL-6.Enzyme-linked immunosorbent assay(ELISA)was used to detect serum TNF-αand IL-6levels,head CT combined with Tada’s formula was used to calculate the patient’s brain edema volume,and National Institutes of Health Stroke Scale(NIHSS)score and Barthel score were used to evaluate the patient’s neurological function.Results The number of patients in the study group with hypertension and diabetes was significantly higher than that in the control group(χ^(2)=19.941,7.751,all P<0.05);the serum levels of TNF-αand IL-6 in the study group were significantly higher than those in the control group(t=14.728,22.429,all P<0.05).The volumes of cerebral edema in the low-expression group of serum TNF-αand IL-6 at T0,T1 and T2 were significantly smaller than those in the high-expression group(P<0.05).At T1 and T2,the NIHSS scores of the low-expression group of serum TNF-αand IL-6 were significantly lower than those of the high-expression group,while the Barthel scores were significantly higher than those of the high-expression group(P<0.05).Conclusion Serum levels of TNF-αand IL-6 in patients with cerebral hemorrhage were elevated,which were related to the volume of brain edema and neurological function,and could be used as relevant indicators to reflect the condition of patients with cerebral hemorrhage and predict the prognosis of patients.