急性脑出血患者血清炎症因子和C-反应蛋白的动态监测及在病情恶化中的预测价值

Dynamic monitoring of inflammatory cytokines and C-reactive protein in patients with acute cerebral hemorrhage and its prognostic value

目的探讨急性脑出血患者血清炎症因子和C-反应蛋白(CRP)的动态变化及临床意义。方法测定120例健康对照者及120例急性脑出血患者发病24 h内、3、7 d及14d时血清肿瘤坏死因子(TNF)-α、白介素(IL)-1β、IL-6、IL-8、CRP的水平,并分别将这些指标与出血量的大小、病情严重程度进行相关性分析,利用受试者工作特征曲线分析其对急性脑出血病情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、CRP水平均高于对照组(P<0.05);血清TNF-α、IL-1β、IL-6、IL-8和CRP水平与患者脑出血量大小、病情严重程度呈正相关性(P<0.05);炎症因子和CRP的水平对急性脑出血病情的恶化具有显著的预测价值。结论血清炎症因子和CRP参与了脑出血的病理生理过程,且这些指标对于患者病情具有重要的预测价值。

Objective To explore the dynamic changes of inflammatory cytokines and C-reactive protein（ CRP ） in patients with acute cerebral hemorrhage and its prognostic value. Methods TNF - α , IL-1β, IL-6, IL-8 and C R P were measured in 120 healthy persons and 120 patients after the onset of acute cerebral hemorrhage at 24 h, 3, 7 and 14 d. Correlation analyzes were performed respectively between bleeding quantity or serious degree in patients with acute cerebral hemorrhage and the above indicators. Receiver operating characteristic curve was emploied to a-nalysis its clinical prediction significance to the deterioration of acute cerebral hemorrhage. Results Different peri-ods of serum TNF-α , IL-1β, IL-6, IL-8, and CRP in patients with acute cerebral hemorrhage were higher than those in healthy controls （P 〈0. 05） . There was a positive correlation between brain bleeding quantity or severity and the contents of TNF-α , IL-1β, IL-6, IL-8, and CRP in patients with acute cerebral hemorrhage（P 〈0. 05）. The inflammatory cytokines and CRP in the patients had its clinical prediction significance to the deterioration of a-cute cerebral hemorrhage. Conclusion T he serum levels of inflammatory cytokines and CRP is involved in cerebral hemorrhage in the pathophysiological process,and these indicators have important predictive value for patients.