急性颅脑损伤患者细胞因子与NSE水平变化的临床意义

Dynamic changes and clinical significance of serum cytokines and neuron specific enolase of patients with acute brain injury

目的探讨急性颅脑损伤患者肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及神经元特异性烯醇化酶(NSE)水平的变化。方法测定80例急性颅脑损伤患者和30例正常对照者的血清TNF-α、IL-6及NSE水平,并分析各参数之间的相关性。结果颅脑损伤患者TNF-α(3.9±1.1ng/L)、IL-6(189.8±42.6ng/L)及NSE(28.7±8.5ng/L)水平显著高于对照组(0.7±0.3ng/L,68.5±22.7ng/L,8.1±4.2ng/L),P<0.01,轻、中、重型颅脑损伤患者TNF-α、IL-6及NSE水平差异有统计学意义(P<0.05);NSE与TNF-α及IL-6水平正相关,相关系数分别为0.85(P<0.01)和0.88(P<0.01)。结论TNF-α、IL-6及NSE在急性颅脑损伤中具有重要作用,并与病情严重程度密切相关,病程早期检测TNF-α、IL-6及NSE水平有助于中、重型颅脑损伤的预测。

Objective To explore the relationship of serum eytokines and neuron specific enolase level in patients of acute brain injury. Methods Serum interleukin-6（IL-6）,tumor necrosis factor-alpha（TNF-α）and neuron specific enolase（NSE）were measured in acute brain injury （80 cases）and control group （30 cases）. The relations between these indices were assayed. Results Serum levels of TNF-α, IL-6 and NSE had significant difference with controls group. TNF-α,IL-6 and NSE levels in serum in patients with severe brain injury were significantly higher than in those with mild brain injury（P〈0.05 ）. NSE was posi- tive correlated with TNF-α, IL-6, r=0.85,0.80 respectively, which were very significantly different （P〈0.01）. Conclusions TNF-α,IL-6 and NSE levels in plasma had significantly correlated with degree of injury severity. The measurement of TNF-α,IL-6 and NSE levels in serum may contribute to predict the severity of brain injury.