急性脑出血患者血清炎症因子和氧化应激产物的动态监测及其临床意义

The change of inflammatory cytokines and products of oxidative stress in the patients with acute cerebral hemorrhage and its clinical significance

目的探讨急性脑出血患者血清炎症因子和氧化应激产物的动态变化及临床意义。方法测定180例健康对照者及180例急性脑出血患者发病24 h内、3 d、7 d及14 d时血清TNF-α、IL-1β、IL-6、IL-8、超氧化物歧化酶、丙二醛和总抗氧化能力的含量,并分别将以上指标与急性脑出血出血量大小、病情严重程度进行相关性分析,利用ROC曲线分析其对急性脑出血恶化的临床预测意义。结果急性脑出血患者不同时期内血清TNF-α、IL-1β、IL-6、IL-8、超氧化物歧化酶、丙二醛含量均高于正常对照组,而总抗氧化能力含量则低于正常对照组;血清TNF-α、IL-1β、IL-6、IL-8和超氧化物歧化酶、丙二醛血清浓度与患者脑出血量大小、病情严重程度呈正性相关,总抗氧化能力呈显著负相关;炎症因子和氧化应激产物的血清浓度对急性脑出血恶化具有显著的预测价值。结论血清炎症因子和氧化应激产物参与了脑出血的病理生理过程,对于患者病情控制、预后改善具有重要临床意义。

Objective To investigate the change of inflammatory cytokines and products of oxidative stress in the patients with acute cerebral hemorrhage and its clinical significance. Methods TNF-α, IL-1β, IL-6, IL-8, SOD, MDA and T-AOC were measured in 180 healthy persons and 180 patients after the onset of ACH at 24 h, 3 d, 7 d and 14 d. Correlation analyzes were performed respectively between bleeding quantity or serious degree in patients with ACH and the above indicators. ROC curve was exploited to analysis its clinical prediction significance to the deterioration of ACH. Results TNF-α, IL-1β, IL-6, IL-8, SOD and MDA in ACH patients were higher than those in healthy controls, and T-AOC was lower; There was a positive correlation between brain bleeding quantity or severity and the contents of TNF-α, IL-1β, IL-6, IL-8, SOD and MDA in ACH patients. There was a negative correlation between the size of brain bleeding or serious degree and the contents of T-AOC. The inflammatory cytokines and products of oxidative stress in the patients had its clinical prediction significance to the deterioration of ACH. Conclusions The inflammatory cytokines and products of oxidative stress can participate in the severity of the brain edema in ACH patients. It has important clinical significance for patients with disease control and improved prognosis.