颅脑损伤早期血清炎性细胞因子的变化与预后关系分析

摘要

目的：探讨颅脑损伤患者早期血清中肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）和白细胞介素8（IL-8）变化与预后之间的关系及其临床意义。方法选取2012年3月至2014年3月期间，在本院住院的急性颅脑损伤患者80例作为观察组，并按照格拉斯哥昏迷评分标准（GCS）分为两组，其中颅脑损伤中重型（3~12分）40例，轻型（13-15分）40例；同时选择本院同期健康体检志愿者共80例为正常对照组；分别采用放射免疫法及酶联免疫吸附试验（ELISA）测定各组血清中TNF-α、IL-6和IL-8的含量水平，并且分析血清中TNF-α、IL-6和IL-8的含量与颅脑损伤程度的关系。结果住院后第1天颅脑损伤组血清中TNF-α、IL-6和IL-8水平均显著高于正常对照组（P＜0.05）；且发现所有时间点中重度组的炎症因子TNF-α、IL-6和IL-8水平均显著性高于轻度组（P＜0.05）；所有患者入院1个月后，按照格拉斯哥评分（GOS）评定患者，预后良好30例，预后不良60例，对比两组炎症因子水平，发现预后不两组患者TNF-α、IL-6和IL-8水平均显著高于预后良好组（P＜0.05）。结论血清中TNF-α、IL-6和IL-8水平可作为判断颅脑损伤严重程度的指标，其联合检测敏感性和特异性均较高，对颅脑损伤的早期诊断及预后判断意义重大。%Objective To explore the relationship between prognosis and necrosis factor alpha (TNF alpha), interleukin 6 (IL-6) and inter-leukin 8 (IL-8) in patients with traumatic brain injury, as well as its clinical significance. Methods From March 2012 to March 2014 in our hos-pital 80 cases with acute traumatic brain injury were chosen as the observation group, and were divided into two groups according to the Glasgow coma scale (GCS) standard, including the medium and severe craniocerebral injury group 40 cases (3 to 12 point), and the light injury group 40 cases (13 to 15 point); A total of 80 normal volunteers in the same period were chosen as the control group. TNF alpha, IL-6 and IL-8 levels were respectively determined by the radioimmunoassay method and the enzyme-linked immunosorbent assay (ELISA), and the relationship of TNF alpha, IL-6 and IL-8 relationship with the degrees of craniocerebral injury were carefully studied. Results After the first day in hospital the serum TNF alpha, IL-6 and IL-8 levels in the observation group were significantly higher than that in the control group ( P<0.05). And at all time points the inflammation factor of TNF alpha, IL 6 and IL 8 levels in the severe and mild group were significantly higher than those in the light group ( P<0.05). After one month in hos-pital, all patients were divided into the good prognosis group (30 cases) and the bad prognosis group (60 cases) according to the Glasgow score (GOS). And TNF alpha, IL-6 and IL-8 levels in the bad prognosis group were significantly higher than those in the good prognosis group ( P<0.05). Con-clusion The serum TNF alpha, IL-6 and IL-8 levels could be used as indexes to judge the severity of traumatic brain injury, and the joint detection has higher sensitivity and specificity, which is of great significance for early diagnosis and prognosis of traumatic brain.