颅脑损伤程度与血清中IL-6、TNF-α含量水平的关系

Relationship of Cerebral Injury and Serous IL-6、TNF-α

目的探讨白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)在不同程度颅脑损伤患者的变化及其对预后的影响。方法采用ELISA法,放射免疫法,测定轻度颅脑损伤(GCS13￣15分)46例、中度(GCS9￣12分)53例、重度(GCS3￣8分)63例入院第2d早期血清中IL-6、TNF-α含量水平,另设30例健康体检者作对照。所有颅脑损伤者于伤后1年进行格拉斯哥结果分级(GOS)。结果与对照组比较,所有颅脑损伤患者入院第2d均明显升高(P<0.05,P<0.01);入院第2d中度较轻度颅脑损伤患者升高更显著(P<0.05),重度较中度颅脑损伤者明显升高(P<0.05)。同等条件下,IL-6<200ng/ml、TNF-α<1.30ng/ml以下各组间GOS比较无显著性意义(P>0.05);IL-6>200ng/ml、TNF-α>1.30ng/ml以上组与IL-6<200ng/ml、TNF-α<1.30ng/ml以下各组间GOS良好率、中残率比较均存在明显差异(P<0.05,P<0.01),但对重残率无影响(P>0.05)。结论颅脑损伤程度不同早期血清中IL-6、TNF-α含量水平不同。其含量水平在IL-6>200ng/ml、TNF-α>1.30ng/ml以上时,对GOS良好率、中残率影响较显著,但对重残率无影响。

Objective To investigate the change of serous interleukin-6(IL-6)?Tumor necrosis factor alpha(TNF-α)in patients with cerebral injury and the effect to prognosis.Methods Serum IL-6?TNF-αwas measured in 46 patients with light cerebral injury(GCS13~15)?53 patients with medial cerebral injury(GCS9~12)?63 patients with severe cerebral injury(GCS3~8) and 30 control health individuals by the ELLISA and radioimmunoassay on the second day in hospital. All the patients were undergo Glasgow outcome scale (GOS) after 1 year. Results The serous IL-6?TNF-αincrease significantly in all the patients with cerebral injury compared with the control on the second day in hospital(P<0.05,P<0.01).The change of serous IL-6?TNF-αwas significant compared between the light cerebral injury and the medial cerebral injury(P<0.05), and between the medial cerebral injury and the severe cerebral injury(P<0.05).No significance existed between the groups when IL-6<200ng/ml?TNF-α<1.30 ng/ml.. The rate of healing and the rate of medial deformity was significant different between the group with IL-6<200ng/ml and the group with IL-6>200ng/ml, and between the group with TNF-α<1.30 ng/ml and the group with TNF-α>1.30 ng/ml. There was no significance in severe deformity between the groups.Conclusion The serous IL-6?TNF-αwas significantly different in the earlier time between patients with light,medial and severe cerebral injury. When the IL-6>200ng/ml ,TNF-α>1.30 ng/ml, the rate of healing and the rate of medial deformity in GOS was significant different, but the rate of severe deformity was not significantly different.