脑脊液和血清内皮素-1,白介素-1β,白介素-6检测对急性颅脑损伤严重程度的评估意义

Significance of ET-1,IL-1β,IL-6 in Serum and CSF of Patientswith Acute Craniocerebral Injury

目的 探讨急性颅脑损伤患者脑脊液（cerebrospinal fluid,CSF）及血清（serum,S）中内皮素-1（endothelin-1,ET-1）、白介素-1β（interleukin-1β,IL-1β）和白介素-6（interleukin-6,IL-6）含量改变及其临床意义.方法 36例急性颅脑损伤患者以格拉斯哥昏迷指数（glasgow coma scale,GCS）进行评估后分组：GCS≤12分为中/重型颅脑损伤组,GCS〉12分为轻度颅脑损伤组;采用双抗体夹心法（ELISA）对患者CSF和血清中ET-1,IL-1β和IL-6浓度进行检测.结果 36例颅脑损伤中,中、重度颅脑损伤组血清（107.02±17.25 μg/L）和CSF（38.89±9.50 μg/L）中ET-1与轻度损伤组血清（46.21±11.19 μg/L）和CSF（22.25±8.55 μg/L）相比差异有统计学显著性意义（t=12.179,P=0.000;t=5.453,P=0.000）;且血清ET-1浓度高于CSF,差异有统计学显著性意义（t=10.378,P=0.000）.中、重度颅脑损伤组血清（11.17±3.68 μg/L）和CSF（9.24±4.01 μg/L）中IL-1β与轻度损伤组血清（5.78±1.89 μg/L）和CSF（5.09±1.97 μg/L）相比差异有统计学显著性意义（t=5.305,P=0.000;t=3.771,P=0.001）,且血清IL-1β浓度高于CSF（t=2.872,P=0.007）,存在明显差异.中、重度颅脑损伤组血清（4.65±1.54 μg/L）和CSF（5.50±1.99 μg/L）中IL-6与轻度损伤组血清（3.23±1.30 μg/L）和CSF（3.41±1.29 μg/L）比较,差异有统计学显著性意义（t=2.947,P=0.006;t=3.627,P=0.001）,但CSF中IL-6浓度高于血清IL-6浓度,差异有统计学显著性意义（t=2.594,P=0.014）.结论 急性颅脑损伤患者ET-1,IL-1β和IL-6水平与颅脑损伤的程度有关.

Objective To elucidate clinical significance of the varied concentration of cytokines in patients, the concentration of endothelin-1 （ET-1）,interleukin-1β （IL-1β）,interleukin-6 （IL-6） in cerebrospinal fluid （CSF） and sera were investigated in 36 patients with acute craniocerebral injury. Methods In this study,36 patients with acute craniocerehral injury were in-vestigated. They were divided into two groups by their Glasgow Coma Scale （GCS） scores （GCS≤12 as moderate-severe in-jury groups, GCS〉 12 as mild injury groups）. Concentration of ET-1, IL-1β, IL-6 in CSF and sera were detected by ELISA in patients with acute cranioeerebral injury. Results The concentration of ET-1 in sera （107.02 ± 17.25 μg/L） and CSF （38. 89±9.50 μg/L） of moderate to severe patients with acute craniocerebral injury were significantly higher than that of in sera （46.21±11.19 μg/L） （t=12. 179,P=0. 000） and CSF （22. 25±8. 55 μg/L） （t=5. 453,P=0. 000） of the mild injury groups. At the same time, the concentration of ET-1 in sera was higher than that of in CSF （t = 10. 378, P = 0. 000）. The levels of IL-1β was 11.17±3.68 μg/L in sera and 9. 24±4. 01 μg/L in cerebrospinal fluid in moderate to severe patients, which were significantly higher than that of in sera （5.78 ±1.89 μg/L） （t= 5. 305, P= 0. 000） and CSF（5. 09±1. 97 μg/L） （t=3. 771,P=0. 001） of the mild injury groups. And the concentration of IL-1β in sera in the moderate to severe injury groups were obviously higher than that of in the mild injury groups （t = 2. 872, P = 0. 007）. Moreover, the concentration of Ii,-6 in the sera and CSF of the moderate to severe injury groups were 4.65±1.54 μg/L and 5. 50±1.99 μg/L, respective-ly, which was significantly higher than that of in sera （3.23 ±1.30 μg/L） （t= 2. 947,P= 0. 006） and CSF （3. 41±1.29μg/ L） （t=3. 627, P=0. 001） of in the mild injury groups. But the concentration of IL-6 in CSF was higher than that of in sera （t=-2. 594,P=0. 014）. Conclusion The concentration of ET-1 ,IL-1β,IL-6 in CSF and sera in patients with acute cranioce-rebral injury were associated with the levels of acute craniocerebral injury.