脑外伤患者检测血浆IL-11的临床评价

Determination of Plasma Interleukin-11 in Patients with Traumatic Brain Injury and Its Clinical Assessment

目的:揭示脑外伤患者血浆白介素-11(IL-11)浓度的变化,探讨其在脑损伤中的作用及对预后的预测价值。方法:收集重型脑外伤患者作为脑外伤组,共112例。收集同期健康体检正常人作为正常对照组,共40例。正常对照组静脉血体检时获得。脑外伤组静脉血在入院时获得。ELISA测定血浆IL-11浓度。结果:脑外伤后1个月内死亡31例(27.7%)。血浆IL-11浓度(25.8±10.4)pg/ml显著高于正常对照组(10.9±3.2)pg/ml(P<0.001)。入院时GCS评分与血浆IL-11浓度呈显著负相关(r=-0.616,P<0.001)。Logistic回归分析显示,入院时血浆IL-11浓度(OR=1.231,95%CI=1.110～1.349,P<0.01)是脑外伤后1个月内死亡的危险因素。ROC曲线分析显示,血浆IL-11浓度预测脑外伤后1个月内死亡有显著预测价值(曲线下面积=0.798,95%CI=0.704～0.875,P<0.001),且判定血浆IL-11浓度截止值为27.4pg/ml,对预测脑外伤后1个月内死亡有80.7%的灵敏度和74.1%的特异度。结论:脑外伤后血浆IL-11浓度升高,可能参与脑损伤的炎症反应,临床检测这个指标有助于早期判断脑外伤患者的预后。

Objective In this study,plasma interleukin-11 level was determined in patients with traumatic brain injury and its correlation with outcome was evaluated.Methods 112 consecutive patients with isolated severe traumatic brain injury and 40 age and sex-matched healthy controls were enrolled into this study.Plasma samples were obtained on entry in healthy controls,as well as on admission in the patients.Its concentration was measured by ELISA.Results 31 patients（27.7%） died from traumatic brain injury in a month.Plasma interleukin-11 level was substantially higher in the patients than that in healthy controls（25.8±10.4 vs 10.9±3.2 pg/ml;P〈0.001）.On admission,GCS score was negatively associated with plasma interleukin-11 level（r=-0.616,P〈0.001）.A multivariate analyses selected plasma interleukin-11 level as an independent predictor for 1-month mortality of patients（OR=1.231,95%CI=1.110~1.349,P〈0.01）.A receiver operating characteristic curve identified cutoff level of plasma interleukin-11（27.4 pg/ml） that predicted 1-month mortality of patients with the high sensitivity（80.7%）and specificity（74.1%）（Area under curve=0.798,95%CI=0.704~0.875,P〈0.001）.Conclusion Increased plasma interleukin-11 level is found after traumatic brain injury,and may contribute to the inflammatory process,in association with a poor clinical outcome.