急性颅脑损伤患者血清TNF—α,IL-6，NSE检测的临床意义

Clinical study of serum TNF-α,IL-6 and NSE in traumatic braininjury

目的研究血清肿瘤坏死因子-α（tumor necrosis factor Alpha，TNF-α）、白细胞介素6（Interleukin-6，IL-6）、神经元特异性烯醇化酶（neuron—specificenolase，NSE）的动态变化对急性颅脑损伤患者病情和预后的评估意义。方法选取2014年1月-2015年12月华北石油管理局总医院治疗的颅脑损伤患者67例，按GCS评分分为轻、中、重型损伤三组，自健康人群选取对照组20例。比较各组颅脑损伤后第1、3、7天TNF-α，IL-6，NSE的区别、动态变化，以及和预后的相关性。结果颅脑损伤患者TNF-α，IL-6，NSE分别于损伤后3d、1d、1d达到高峰（P〈0．05）。重度颅脑损伤患者IL-6，TNF-α和NSE水平显著高于中、轻度损伤患者（P〈0．05）。入院时TNF—α，IL-6和NSE水平越高，预后效果越差（P〈0．05）。结论TNF-α，IL-6，NSE对颅脑损伤患者的病情和预后具有重要的评估意义，高水平状态提示预后不佳。

Objective To investigate the serum concentration of TNF-α,IL-6 and NSE in patients with acute brain trauma and evaluate their values in diagnosis and treatment. Methods 67 cases of patients with traumatic brain injury from the General Hospital of North China Petroleum Bureau were divided into three groups based on the GCS coma scale. The differences of TNF-α, IL-6 and NSE were respectively compared among the three groups in 1, 3, 7 days. The correlation of TNF-α, IL-6 and NSE with prognosis were analyzed. Results IL-6, TNF-α和 NSE PCT and IL-6 levels had no differences between death and survival group （P 〉0.05）. After injury, TNF-α,IL-6 and NSE reach to the peak in the 3rd day, lst day and 1st day, respectively（P 〈0.05）.In the severe traumatic brain injury group, the level of TNF-α,IL-6 and NSE were significantly higher than those in other groups （P 〈0.05）. The correlation analysis showed the negative correlation of prognosis and the level of TNF-α,IL-6,NSE （P 〈0.05 ）. ConclusionsTNF-α, IL-6 and NSE play assess significantly important roles in acute brain trauma and their prognosis. The serum TNF-α, IL-6 and NSE levels at a higher state indicate a poor prognosis in traumatic brain injury patients.