Th1类细胞因子在评价高血压性脑出血手术疗效的作用

Application of Th1-type cytokines on evaluating the surgical effect for patients with hypertensive intracerebral hemorrhage

目的探讨Th1类细胞因子在评价高血压性脑出血手术疗效的作用。方法收集38例接受小骨窗开颅血肿清除术的患者作为观察组,采集其静脉血及术中吸附的血肿,采用ELISA检测其内Th1细胞因子白介素2(IL-2)及γ干扰素(IFN-γ)和Th2细胞因子白介素4(IL-4)及白介素10(IL-10)的含量。通过CT扫描测量血肿体积;通过NIHSS评分评价急诊时患者的神经功能缺损情况;检测急诊时中性粒细胞计数及C-反应蛋白水平及皮质醇以判断患者的应激程度。同时选取38例接受保守治疗的患者作为对照。结果①急诊时手术组的IL-2及IFN-γ均显著高于保守组,但IL-4及IL-10无统计学差异(P<0.05)。②治疗24h后,手术组患者的IL-2及IFN-γ显著低于急诊时(P<0.05),且IL-4及IL-10显著高于急诊时;治疗后24h保守组的IL-2及IFN-γ同样显著低于急诊时,但IL-4及IL-10与急诊时无统计学差异。③血清及血肿内IL-2及IFN-γ与血肿体积、皮质醇、中性粒细胞计数及C-反应蛋白均呈正相关性(r>0.05,P<0.05)。结论血清及血肿内Th1细胞因子IL-2及IFN-γ与出血量及应激存在显著正相关性,因此该类细胞因子可有效评价小骨窗开颅血肿清除术治疗高血压性脑出血的疗效。

Objective To explore the application of Th1-type cytokines on the evaluating the surgical effect for patients with hypertensive intracerebral hemorrhage（HIP）.Methods There were 38 patients with HIP who underwent evacuation of hematoma and were grouped as surgical group.There were another 38 ones who received non-surgical treatment and grouped as the control group.For all the patients,the serum cytokines were detected via ELISA;CT scanning was applied to calculate the size of the hematoma.Moreover,the level of neutrophil,C-reactive protein（CRP） and cortisol（Cor） were also detected to reflect the degree of stress.Results ①Concentration of IL-2 together with IFN-γ in surgical group were significantly higher than those in the non-surgical one before treatment（P0.05）,but IL-4 and IL-10 not.②For both surgical and non-surgical group,the post-operative（24 hrs） concentration of IL-2 and IFN-γ were significantly lower than those before surgery（P0.05）.③ IL-4 and IL-10 in the surgical group were significantly higher than those before treatment（P0.05）,but not the non-surgical group.④ IL-2 and IFN-γ in serum and hemorrhage correlated with the volume,Cor,Neu and CRP positively（all r0.05 and P0.05）.Conclusion IL-2 and IFN-γ,the cytokines belonging to Th1,related to the volume of hemorrhage and the level of stress.Thus,the two cytokines can be used to evaluate the surgical effect of for patients with hypertensive intracerebral hemorrhage.