颅脑损伤患者外周血白细胞介素-18、基质金属蛋白酶-9水平与迟发性颅内脑血肿的相关性

The Correlation Between Peripheral Blood Interleukin-18,Matrix Metalloproteinase-9 Levels and Delayed Intracranial Hematoma in Patients with Traumatic Brain Injury

目的探讨颅脑损伤(TBI)患者外周血白细胞介素-18(IL-18)、基质金属蛋白酶-9(MMP-9)水平与迟发性颅内脑血肿(DTIH)的相关性。方法选取2021年4月至2022年8月医院收治的88例TBI患者作为研究对象。所有患者治疗后经2次及以上头颅CT平扫,根据是否发生DTIH分成DTIH组(45例)和非DTIH组(43例)。收集患者的一般资料,采用酶联免疫吸附法检测患者IL-18、MMP-9,采用单因素分析及Logistic多因素回归分析法分析影响发生DTIH的因素。结果单因素分析结果提示,DTIH组的舒张压、血浆凝血酶时间(TT)、IL-18及MMP-9水平高于非DTIH组,而格拉斯哥昏迷指数(GCS)评分低于非DTIH组,差异有统计学意义(P<0.05)。多因素分析结果提示,IL-18(β=0.294,OR=1.342,95%CI=1.044~1.724)及MMP-9(β=0.298,OR=1.347,95%CI=1.093~1.659)是TBI患者发生DTIH的危险因素(P<0.05)。结论IL-18和MMP-9表达异常升高与TBI患者治疗后发生DTIH相关,两者均为TBI患者发生DTIH的危险因素。

Objective To explore the correlation between peripheral blood levels of interleukin-18(IL-18)and matrix metalloproteinase-9(MMP-9)and delayed intracranial hematoma(DTIH)in patients with traumatic brain injury(TBI).Methods A total 88 TBI patients admitted to the hospital from April 2021 to August 2022 were selected as the study subjects.After treatment,all patients underwent 2 or more head CT scans.According to whether DTIH occurred after treatment,they were divided into DTIH group(45 cases)and non DTIH group(43 cases).General information of the patients was collected,and IL-18 and MMP-9 were detected by enzyme-linked immunosorbent assay.Univariate analysis and logistic multiple regression analysis were used to identify the factors affecting the occurrence of DTIH.Results The diastolic blood pressure,plasma thrombin time(TT),IL-18,and MMP-9 in the DTIH group were higher than those in the non DTIH group,while the Glasgow Coma Index(GCS)score was lower than that in the non DTIH group,with statistical significance(P<0.05).The results of multiple factor analysis suggest that IL-18(β=0.294,OR=1.342,95%CI=1.044-1.724)and MMP-9(β=0.298,OR=1.347,95%CI=1.093-1.659)was a risk factor for DTIH in TBI patients(P<0.05).Conclusion The abnormal expression of IL-18 and MMP-9 is related to the occurrence of DTIH in patients after treatment,and both are risk factors for DTIH in TBI patients.