颅脑损伤患者血清及CSF内IL-1β、IL-6的表达与损伤程度的相关性研究

The relationship between IL-1β, IL-6 in serum and cerebro-spinal fluid and severity of traumatic brain injury

目的探讨IL-1β、IL-6与颅脑损伤（TBI）程度的关系及临床意义。方法 2010年1月~2012年12月我院收治的TBI患者231例,于伤后1 d、3 d、7 d、10 d检测血清及脑脊液（CSF）中IL-1β及IL-6水平。根据格拉斯哥昏迷量表评估损伤程度,将患者分为轻型组72例、中型组84例、重型组75例,比较三组IL-1β及IL-6水平。伤后6个月,根据格拉斯哥预后量表评估显示,死亡28例、植物生存3例、重残25例、中残31例、恢复良好144例。比较不同预后患者IL-1β及IL-6水平。结果轻型组及中型组IL-1β、IL-6水平无明显差异,但两者均低于重型组（P〈0.05）。死亡、植物生存患者IL-1β、IL-6水平无明显差异,但两者均高于重残患者（P〈0.05）。死亡、植物生存及重残患者IL-1β、IL-6水平均高于中残及预后良好患者（P〈0.05）。结论血清及脑脊液中IL-1β、IL-6水平与TBI损伤程度及预后密切相关。

Objective To investigate the relationship of interleukin （IL）-1β and IL-6 levels of patients with the severity of traumatic brain injury （TBI） and their clinical significance. Methods A total of 231 patients with TBI admitted to our hospital from Jan 2010 to Dec 2012 were measured the levels of IL-1β and IL-6 in serum and cerebro-spinal fluid. All the patients were divided into mild injury group（72 cases） , moderate injury group （84 cases） , severe injury group （75 cases） according to the Glasgow coma scale, levels of IL-1β and IL-6 of the three groups were compared. They were divided into different groups according to the prognosis evaluated by Glasgow coma scale after treatment 6 months, death 28 cases, vegetable survival 3 cases, severe disability 25 cases, moderate disability 31 cases, good recovery 144 cases, IL-1β and IL-6 of patients with different prognosis were compared. Results IL-1β and IL-6 levels were signifi cantly increased in mild injury group, moderate injury group, severe injury group compared with control group（P〈0.05）. IL-1β and IL-6 inmild injury group,moderate injury group were lower than those in severe injury group（P〈0.05）. There was no significantly difference in IL-1β and IL-6 between mild injury group and moderate injury group（P〉0.05）. IL-1β and IL-6 of the death and vegetable survival were higher than those of severe disability. IL-1β and IL-6 of death, vegetable survival, and severe disability were higher than those of moderate disability and good recovery（P〈0.05）. Conclusion The levels of IL-1β and IL-6 in serum and CSF are closely related to the severity of TBI and can be used as clinical monitoring indices.