脑出血患者外周血TLR4、TNF-α、IFN-γ水平与预后的关系

Relationship between the levels of TLR4, TNF-α and IFN-γ in peripheral blood and prognosis in patients with cerebral hemorrhage

目的探究脑出血患者外周血中Toll样受体4(TLR4)、肿瘤坏死因子-α(TNF-α)、γ干扰素(IFN-γ)水平与预后的关系。方法回顾性分析2016年2月至2018年2月间咸阳市第一人民医院收治的113例脑出血患者的临床资料,患者出院后随访3个月,根据患者的生存情况分为生存组82例、死亡组31例,比较两组患者入院及出院时的外周血TLR4、TNF-α、IFN-γ水平,并采用Logistics回归分析其与患者预后的关系。结果两组患者入院时的TLR4、TNF-α、IFN-γ水平比较差异均无统计学意义(P>0.05);两组患者出院时的TLR4、TNF-α、IFN-γ水平与入院时比较,差异均具有统计学意义(P<0.05),其中死亡组患者出院时的TLR4、TNF-α、IFN-γ水平分别为(27.43±14.53)μg/L、(19.80±2.64)ng/L、(366.33±18.77)pg/mL,明显高于生存组患者的(13.61±5.83)μg/L、(11.37±3.85)ng/L、(185.65±14.82)pg/mL,差异均具有统计学意义(P<0.05);以患者出院时的TLR4、TNF-α、IFN-γ水平作为自变量,以患者预后情况(死亡及生存)为因变量,经Logistics回归分析结果显示,TLR4、TNF-α、IFN-γ水平为脑出血患者预后的独立危险因素(P<0.05)。结论脑出血患者外周血TLR4、TNF-α、IFN-γ水平均与其预后有关,且TLR4、TNF-α、IFN-γ水平为独立危险因素,故临床中可将脑出血患者的TLR4、TNF-α、IFN-γ水平变化作为评估患者预后的预测指标。

Objective To explore the relationship between Toll-like receptor 4 (TLR4), tumor necrosis factor- alpha (TNF-α), interferon gamma (IFN-γ) and prognosis in patients with cerebral hemorrhage. Methods The clinical data of 113 patients with cerebral hemorrhage admitted to the First People's Hospital of Xianyang City from February 2016 to February 2018 were retrospectively analyzed. The patients were followed up for 3 months after discharge, and they were divided into survival group (82 cases) and death group (31 cases). The peripheral blood TLR4, TNF-α, and IFN-γ levels of the two groups were compared at admission and discharge. Meanwhile, logistic regression was used to analyze the relationship between prognosis and prognosis. Results There were no significant differences in the levels of TLR4, TNF-α, and IFN-γ between the two groups at admission (P>0.05). The levels of TLR4, TNF-α, and IFN-γ at the time of discharge in the two groups showed statistically significant differences with the levels at admission (P<0.05). The TLR4, TNF-α, and IFN-γ levels in the death group were (27.43±14.53)μg/L,(19.80±2.64) ng/L, and (366.33± 18.77) pg/mL, respectively, which were significantly higher than (13.61±5.83)μg/L,(11.37±3.85) ng/L, and (185.65± 14.82) pg/mL in the survival group (P<0.05). Taking TLR4, TNF-α, IFN-γ levels at discharge as independent variables and patients' prognosis (death and survival) as dependent variable, logistic regression analysis showed that TLR4, TNF-α, and IFN-γ levels were the independent risk factors for prognosis in patients with cerebral hemorrhage (P<0.05). Conclusion The levels of TLR4, TNF-α, IFN-γ in peripheral blood of patients with cerebral hemorrhage are related to their prognosis, and they are the independent risk factors. Therefore, the changes of TLR4, TNF-α, and IFN-γ levels in patients with cerebral hemorrhage can be used as predictive indicators of prognosis.