急性颅脑损伤颅内出血患者治疗前后测定血浆Cortisol、TNF-α和IL-6水平的临床意义

Clinical Significance of Determination the Changes of Plasma Cortisol,TNF-α and IL-6 Levels in Patients with Acute Brain Injury Intracranial Bleeding Both Before and After Therapy

目的:为了探讨急性颅脑损伤颅内出血患者治疗前后测定血浆皮质醇(cortisol)、TNF-α和IL-6水平的临床意义。方法:RIA和超敏免疫分析测定了84例急性颅脑损伤颅内出血患者(其中46例重症和38例轻症)治疗前后血浆皮质醇、TNF-α和IL-6水平,并与35例正常对照组进行了比较性分析。结果:84例急性颅脑损伤颅内出血患者治疗前血浆皮质醇(8h和24h)、TNF-α和IL-6水平均较35例正常对照组明显增高(P均<0.01),而且重症明显高于轻症(P均<0.05),表示其随着疾病的严重程度而增加。治疗后,32例重症患者血浆皮质醇(8h和24h)、TNF-α和IL-6水平明显降低(P<0.05～<0.01)。30例轻症患者血浆皮质醇(8h和24h)、TNF-α和IL-6水平恢复正常(P均>0.05)。结论:血浆皮质醇(8h和24h)、TNF-α和IL-6水平的增加是急性颅脑损伤颅内出血的应激反应,并参与病理生理过程,是观察治疗效果和预后的有效指标。

Objective To explore clinical significance of determination of change of plasma cortisol,TNF-αand IL-6 levels in patients with acute brain injury intracranial bleeding both before and after therapy.Methods RIA determined plasma cortisol,TNF-α levels and high-sensitive immunoassay measured plasma IL-6 levels in 84 patients with acute brian injury intracranial bleeding both before and after therapy and 35 normal controls.Results Before therapy,plasma cortisol（8h and 24h）,TNF-α and IL-6 levels were significantly higher in 84 patients with acute brain injury intracranial bleeding than those in 35 controls（P all 0.01）.But the severe patients were markedly higher than mild patients,and it was increased with severity.After therapy,plasma cortisol（8h and 24h）,TNF-α and IL-6 levels in 32 severe patients were dramatically lower（P0.05~0.01）,Plasma cortisol（8h and 24h）,TNF-α and IL-6 levels in 30 mild patients were return to normal levels（P all 0.05）.Conclusion The increasing plasma cortisol（8h and 24h）,TNF-α and IL-6 levels were urgent reaction on acute brain injury intracranial bleeding and took part in patho-physiological process,and might be utilized as an useful indicator of therapeutic effect as well as prognosis.