细胞因子血管内皮生长因子、白介素-6和D-二聚体在慢性硬膜下血肿发病中的作用分析

The role of cytokines including vascular endothelial growth factor,interleukin-6,and D-dimer in the process of chronic subdural hematoma

目的本文通过检测慢性硬膜下血肿(chronic subdural hematoma,CSDH)患者白介素-6(interleukin 6,IL-6)、血管内皮生长因子(vascular endothelial growth factor,VEGF)及D-二聚体的含量,观察血肿包膜的结构,探讨相关因子在CSDH形成中的作用以及相关治疗进展。方法选取手术治疗观察组患者45例,正常对照组45例,通过免疫组织化学和酶联免疫法分别检测VEGF、IL-6和D-二聚体的表达。结果观察组患者血清VEGF和D-二聚体水平显著高于对照组(P<0.01);IL-6水平与对照组之间无明显差异(P>0.05),而观察组患者血肿液中IL-6、VEGF和D-二聚体水平则明显高于对照组血清水平(P<0.01)。血肿包膜中可见嗜酸性粒细胞等炎症细胞,毛细血管增生,大量红细胞渗出,VEGF表达呈强阳性。结论CSDH血肿腔中IL-6、VEGF和D-二聚体含量明显升高,三者可能是促进CSDH形成的重要原因。

Objective To explore the roles of related factors in the formation of chronic subdural hematoma(CSDH)as well as the related treatment progress by detecting the levels of interleukin(IL)-6,vascular endothelial growth factor(VEGF)and D-dimer in patients with CSDH,observing the structure of the outer membraneof hematoma.Methods Forty-five cases in the observation group and forty-five cases in the control group were selected.The level of VEGF,IL-6 and D-dimer of both groups were detected by immunohistochemistry and enzyme-linked immunosorbent assay.Results The levels of VEGF and D-dimer of patients in the observation group were higher than those in the control group(P<0.01),and there was no significantly difference in the level of IL-6 between two groups(P>0.05).However,the levels of IL-6,VEGF and D-dimer in the hematoma fluid of patients in the observation group were significantly higher than those in the control group(P<0.01).Eosinophils,capillary proliferation and a large number of red blood cells were found in the outer membrane of hematoma.Meanwhile,VEGF was strongly expressed in the outer membrane of hematoma.Conclusion The levels of IL-6,VEGF and D-dimer in the hematoma fluid of CSDH patients were significantly increased,which may be the major reasons for promoting the formation of CSDH.