急性颅脑损伤患者血清TNF-α和IL-2水平的变化及临床意义

Clinical Significance of Changes in Serum TNF-α and IL-2 Levels in Patients with Acute Craniocerebral Injury

目的探讨不同严重程度急性颅脑损伤患者血清肿瘤坏死因子α(TNF-α)和白细胞介素2(IL-2)含量的变化及临床意义。方法将45例急性颅脑损伤患者(颅脑损伤组)按格拉斯哥昏迷评分(GCS)标准分为3组,轻型组(13例)、中型组(20例)和重型组(12例);另选择健康成人30例为正常对照组。分别采用酶联免疫吸附(ELISA)法、放射免疫法检测各组血清IL-2、TNF-α的含量,分析颅脑损伤程度与血清IL-2、TNF-α水平之间的关系。结果颅脑损伤组患者血清IL-2、TNF-α水平均显著高于正常对照组(P<0.01)。颅脑损伤轻型组血清IL-2水平高于正常对照组(P<0.05),血清TNF-α与正常对照组比较差异无统计学意义(P>0.05);中型组和重型组血清TNF-α、IL-2水平均显著高于正常对照组和轻型组(均P<0.05);重型组血清TNF-α、IL-2水平均显著高于中型组(均P<0.05)。颅脑损伤组患者血清IL-2与TNF-α水平之间呈显著正相关(r=0.669,P<0.05),颅脑损伤患者血清IL-2、TNF-α水平与GCS评分均呈显著负相关(r=-0.701,-0.686,P<0.05)。结论 IL-2和TNF-α参与了急性颅脑损伤的病理生理过程,其测定可作为急性颅脑损伤患者早期诊断、判断病情严重程度和预后的重要指标。

Objective To explore the changes in serum TNF-α and II.-2 levels in patients with acute craniocerebral injury and their clinical significance. Methods Forty-five patients with acute craniocerebral injury were divided into three groups based on Glasgow Coma Scale（GCS） ： mild group （13 patients） ,moderate group （20 patients） and severe group （12 patients）. Normal control group consisted of 30 healthy adults. The levels of IL-2 and TNF-α were detected by ELISA and radioimmunoassay,respectively. The relationship between the degree of craniocerebral injury and serum levels of IL-2 and TNF-α were analyzed. Results The levels of IL-2 and TNF-α in patients with craniocerebral injury were higher than those in normal volunteers （P〈0.01）. The levels of IL-2 in mild group were higher than those in control group （P〈0.05）, but differences in TNF- levels were not significant between the two groups （P〉0.05）. The levels of IL-2 and TNF-α in moderate and severe groups were higher than those in control group and mild group（ all P〈0.05）. Furthermore, the levels in severe group were higher than those in moderate group （all P〈0.05 ）. There was a positive correlation between IL-2 levels and TNF-α levels in patients with a- cute craniocerebral injury（r=0. 669,P〈0.05） ,but the levels of IL-2 and TNF-α were negatively correlated with GCS scores（r=0. 701,-0. 686,P（0.05）. Conclusion IL-2 and TNF-α were involved in the pathological process of acute craniocerehral injury, and may be important indexes for early diagnosis, severity evaluation and outcome prediction prognosis in patients with acute craniocerebral injury.