亚低温对重型颅脑创伤患者脑脊液中IL-8含量的影响

Effects and Significance of Moderate Hypothermic Therapy on IL-8 Concentration of CSF in Acute Severe Traumatic Brain Injury

目的:研究急性重型颅脑创伤(sTBI)患者脑脊液中白细胞介素8(IL-8)含量的变化及亚低温治疗对其影响与临床意义。方法:80例急性sTBI患者随机分为亚低温(HT)组和常温(NT)组各40例,采用放射免疫法检测亚低温治疗前(伤后早期)、后不同时段脑脊液中IL-8的含量,同时比较2组患者的颅内压(ICP)、GlasgowOutcmoeScale(GOS)计分指标并分析其间关系。结果:急性sTBI患者伤后早期脑脊液(CSF)中IL-8含量明显增高。与NT组患者比较亚低温治疗后24 h,HT组患者的ICP值和IL-8含量明显降低(P<0.05),并持续至复温后24 h(P<0.01),而IL-8含量在伤后1个月时仍明显低于NT组(P<0.01)。HT组患者伤后6个月时的GOS计分明显高于NT组(P<0.05)。结论:sTBI患者急性期脑脊液中IL-6含量增高,亚低温治疗可降低急性sTBI后的高ICP和明显抑制IL-8超表达,改善临床预后。

Objective： To investigate the changes of interleukin-8 （IL-8） concentration of cerebrospinal fluid （CSF） in the patients with acute severe traumatic brain injury （sTBI） and the effects of moderate hypothermic therapy on IL-8 and its clinical significance. Methods： Eighty sTBI cases were randomly divided into hypothermic therapy （HT） group and normothermic therapy （NT） group. IL-8 concentrations of CSF were tested before （early phase after injury） and after hypothermic therapy by radioimmunoassay. ICP and Glasgow Coma Scale （GCS） score of two groups were compared and analyzed. Results： The IL-8 level increased significantly in early phase after injury in acute sTBI. Twenty-four hours after the moderate hypothermia therapy, the ICP level and IL-8 concentration decreased significantly （P 〈 0.05 ） and lasted for 24 hours after rewarming （P〈 0.01 ） in HT group compared with those in NT group. The IL-8 concentration of HT group decreased significantly 1 month after injury compared with that of NT group （P 〈 0.01 ）. Conclusion： IL-8 level increases in the acute phase of sTBI. The moderate hypothermic therapy will decrease the high level of ICP, inhibit the overexpression of IL-8 significantly and improve the clinical prognosis of acute sTBI.