TNF-α、IL-6、NO在创伤性颅脑损伤病情评估中的作用

摘要

目的：研究TNF-α、IL-6、NO在创伤性颅脑损伤病情评估中的作用。方法选取2010年9月~2014年9月来我院就诊的创伤性颅脑损伤患者36例临床资料进行回顾性研究，将所有患者根据格拉斯哥昏迷评分（GCS）分为轻度、中度、重度颅脑损伤组，每组12例，选取同期来我本院进行体检的健康者12例作为对照组。在所有患者伤后1d、2d、3d、5d、7d、14d分别采集外周静脉血3ml，分离获得血清。使用ELISA方法检测研究对象血清中TNF-α和IL-6水平。使用Greiss检测研究对象血清中NO水平。结果重度损伤组、中度损伤组患者伤后1d、2d、3d、5d、7d、14d的血清中TNF-α和IL-6浓度与对照组比较差异均显著（P<0.05），轻度损伤组患者伤后1d、2d、3d、5d、7d的血清中TNF-α和IL-6浓度与对照组比较差异均显著（P<0.05）。而轻度损伤组患者14d的血清中TNF-α和IL-6浓度与对照组比较差异不显著（P>0.05）。重度损伤组患者伤后1d、2d、3d、5d、7d、14d的血清中NO浓度与对照组比较差异均显著（P<0.05）。轻度损伤组、中度损伤组患者伤后1d、2d、3d、5d、7d的血清中NO浓度与对照组比较差异均显著（P<0.05）。而轻度损伤组、中度损伤组患者伤后14d的血清中NO浓度与对照组比较差异均不显著（P>0.05）。组间比较，血清中TNF-α、IL-6和NO浓度随着病情加重而升高。结论 TNF-α、IL-6、NO对创伤性颅脑损伤病情评估、临床诊断及治疗起到指导作用。%Objective To analyse the role of TNF-α,IL-6,NO in condition assessment of traumatic brain injury. Methods Clinical data of 36 patients with traumatic brain injury (TBI) from Sep 2010 to Sep 2014 in our hospital were retro-spectively analysed. All the patients were divided into mild injury group(GCS 13~15 scores),moderate injury group(GCS 9~12 scores), severe injury group (GCS 3~8 scores) according to Glasgow Coma Scale (GCS), 12 cases in each group, and 12 healthy persons in the corresponding period were selected as control group. The serum level of TNF-α and IL-6 were detected by ELISA method,and the serum level of NO were detected by Greiss method on 1d, 2d, 3d, 5d, 7d, 14d after injury for all the patients. Results Compared with control group,the serum TNF-α, IL-6 and NO level of all the TBI patients had signifi-cant difference on 1d, 2d, 3d, 5d, 7d after injury (P<0.05), the serum TNF-α, IL-6 level of moderate and severe injury group, and the serum NO level of severe injury group had significant difference on 14d after injury (P<0.05). The serum TNF-α, IL-6 and NO level increased with the aggravation of disease. Conclusion The serum level of TNF-α,IL-6 and NO play an important directive role in condition assessment and clinical diagnosis and treatment of traumatic brain injury.