脑出血患者相关炎症因子变化与预后的相关性研究

摘要

Objective:To study the association of the changes of inflammatory factors with prognosis of patients with intracerebral hemorrhage.Method:80 patients with acute intracerebral hemorrhage were recrui-ted and assigned to intracerebral hemorrhage ( ICH) group.80 middle-age or old healthy subjects were re-cruited and assigned to control group.Acute physiology and chronic health evaluation-II( APACHE-II) was conducted in ICH patients to monitor prognosis.Peripheral fasting venous blood in both two groups were col-lected, and serum levels of IL-10, IL-6, IL-1, hs-CRP, TNF-αwere determined.Result:Serum levels of IL-10, IL-6, IL-1, hs-CRP, TNF-αin ICH group were significantly higher than that of control group. Score of APACHE-II in 42 patients were 5-16 ( mild );26 patients were 17-28 ( medium);12 patients were over 29 (severe).Serum levels of IL-10, IL-6, IL-1, hs-CRP, TNF-αwere significantly different in patients with different scores of APACHE-II (P<0.05).Serum levels of IL-10, IL-6, IL-1, hs-CRP, TNF-αin patients with medium and severe ICH were notably higher than that of patients with mild ICH.Ser-um levels of IL-10, IL-6, IL-1, hs-CRP, TNF-αin patients with severe ICH were notably higher than that of patients with medium ICH( P<0.05) .14 patients were dead and 66 patients survived.Serum levels of IL-10, IL-6, IL-1, hs-CRP, TNF-αin dead patients were markedly higher than that of patients alive(P<0.05) .Conclusion:Serum levels of IL-10, IL-6, IL-1, hs-CRP , TNF-αwere increased in patients with ICH.The increase of serum levels of IL-10, IL-6, IL-1, hs-CRP, TNF-αwas more evident in those with severe illness and poor prognosis.Serum levels of IL-10, IL-6, IL-1, hs-CRP , and TNF-αwere closely associated with the severity and prognosis of patients with ICH.%目的：探讨脑出血患者相关炎症因子变化与预后的相关性。方法：选取急性脑出血患者80例为脑出血组、同期门诊中老年体检者80例为对照组，脑出血组入院后进行急性生理和慢性健康状况评分（ APACHE－II）评估，观察预后，脑出血组在入院后、对照组在体检时抽取外周空腹静脉血检测血清白细胞介素－10（IL－10）、白细胞介素－6（IL－6）、白细胞介素－1（IL－1）、敏感C反应蛋白（hs－CRP ）、肿瘤坏死因子－α（ TNF－α）水平。结果：脑出血组患者血清IL－10、IL－6、IL－1、hs－CRP、TNF－α水平均明显高于对照组（P＜0．05）；APACHE－II 评分5－16分者42例（轻型），17－28分者26例（中型），29分以上者12例（重型），不同APACHE－II评分时患者IL－10、IL－6、IL－1、hs－CRP、TNF－α水平比较明显不同（ P＜0．05），中型、重型者均高于轻型（ P＜0．05），重型高于中型（ P＜0．05）；14例患者死亡，66例患者存活，死亡患者IL－10、IL－6、IL－1、hs－CRP、TNF－α水平明显高于存活患者（ P＜0．05）。结论：脑出血患者血清炎症因子IL－10、IL－6、IL－1、hs－CRP、TNF－α等均升高，病情越重、预后不佳的患者升高更为明显，IL－10、IL－6、IL－1、hs－CRP、TNF－α水平与患者病情严重程度及预后关系密切。