急性脑血管病并全身炎症反应综合征及多器官功能障碍综合征患者TNF-α及IL-6水平的变化

The change of TNF-α and IL-6 levels in patients with acute cerebrovascular disease complicated with systemic inflammatory response syndrome and multiple organ dysfunction syndromes T

目的探讨外周血TNF-α及IL-6在急性脑血管病(ACVD)引发全身炎症反应综合征(SIRS)及多器官功能障碍综合征(MODS)发病过程中的变化规律以及与病情变化的相关性。方法对153例患者根据患者病情发展演变特点分为3组:急性单纯脑血管病组(ACVD)、急性脑血管病引发全身炎症反应组(ACVD引发SIRS组)、急性脑血管病引发多器官功能障碍组(ACVD引发MODS组),采用ELISA测定ACVD患者外周血TNF-α及IL-6表达。结果 (1)患者发病第3天TNF-α及IL-6表达明显升高;(2)对于TNF-α及IL-6的表达,ACVD引发SIRS组与单纯ACVD组相比较,P<0.01,ACVD引发MODS组与ACVD引发SIRS组相比较,P<0.01,而且其表达升高的程度均随着病情的加重而呈升高趋势;(3)MODS积分越高,TNF-α及IL-6的表达也越高,且P<0.05;(4)ACVD引发MODS患者中,死亡组与存活组相比较,死亡组的血清TNF-α及IL-6的表达明显高于存活组,P<0.01。结论 IL-6与TNF-α在ACVD发病的急性期可能参与了炎症反应过程,并随着病情的加重而呈现递增趋势。

Objective To investigate the variation of TNF-αand IL-6 in the pathogenesis of the disease in patients with acute cerebrovascular disease （ACVD） leading to systemic inflammatory response syndrome （SIRS） and multiple organ dysfunction syndrome （MODS） as well as the correlation between them and the disease changes. Methods Based on the patient characteristic of the evolution of the disease, 153 patients are divided into three groups： The group of ACVD alone, the group of acute cerebrovascular disease induced systemic inflammatory response, and the group of acute cerebrovascular disease induced multiple organ dysfunction. The method of ELASA was used to measure the expression of TNF-αand IL-6 in the peripheral blood of patients with ACVD. Results The expression of TNF-α and IL-6 was significantly increased in the third day of the disease onset;To the expression of TNF-αand IL-6, there is great difference between the group of ACVD induced SIRS compared with the group of simple ACVD （P＆lt;0.01）, and as well as the group of ACVD induced MODS compared with ACVD induced SIRS （P＆lt;0.01）, in which its elevated expression degree are as the disease worsens and showed an increasing trend;With the MODS integration becoming higher, the expression of TNF-αand IL-6 is also higher （P＆lt;0.05）;In the patient with ACVD induced MODS, TNF-αand IL-6 in the serum of the death group was significantly higher than that of the survival group （P＆lt;0.01）. Conclusion In the acute phase of patients with acute cerebrovascular disease, IL-6 and TNF-αmay be involved in the inflammatory response process, and showed an increasing trend as the disease worsens.