颅脑损伤患者血浆内毒素及肿瘤坏死因子的变化

The changes of serum endotoxin and tumor necrosis factor in patients with brain injury

目的 研究颅脑损伤后继发性脑损伤的机制，探讨内毒素在继发性脑损伤中的可能作用。方法 选择轻、中、重型不同程度颅脑损伤患者３０例，动态观察伤后６小时～７天血浆内毒素及肿瘤坏死因子（ＴＮＦ）的变化并分析其相关性。结果 颅脑损伤后早期血浆内毒素即有显著升高，伤情越重其水平越高，同时ＴＮＦ水平也相继升高，较内毒素水平出现稍晚，并与内毒素水平密切相关。结论 严重颅脑损伤后可出现明显的内毒素血症及炎性细胞因子反应，内毒素可能是引起和加重继发性脑损伤的原因之一。

Objective To study the mechanism of secondary brain injury following brain trauma and investigate the possible the of endotoxin in secondary brain injury after brain trauma. Methods Thirty patients with various degrees of brain trauma were divided into slight, middle, and severe groups. The changes of serum endotoxin and tumor necrosis factor (TNF) were detected dynamically during 6 hours to 7 days after trauma. Results Serum endotoxin raised obviously early in severe brain trauma, changed with the degree of injury. Serum TNF raised soon afterwards, and its level was closely related to serum endotoxin. Conclusion Obvious endotoxemia and inflammatory cytokine reaction may appear early in severe brain trauma. Endotoxin is likely one of the cause resulting in and aggravating secondary brain injury.