床边纤支镜治疗重型颅脑外伤患者肺灌洗液中细胞学、白细胞介素-8及肿瘤坏死因子-α的变化  

Variations of Cytology,IL-8 and TNF-αof Bronchoalveolar Lavaage Fluid After Fiberoptic Bronchoscopy in the Patients with Severe Traumatic Brain Injury

作　　者：朱卫兵[1] 高想[2] 储呈春[1] 张勇军[1] 刘亚军[2] 唐艳芬[2] 

机构地区：[1]南通市中医院神经外科,江苏南通226001 [2]南通市中医院ICU,江苏南通226001

出　　处：《苏州大学学报（医学版）》2007年第6期916-918,951,共4页Suzhou University Journal of Medical Science

摘　　要：目的探讨应用床边纤支镜治疗对重型颅脑外伤患者肺灌洗液中细胞学、白细胞介素-8(IL-8)及肿瘤坏死因子-α(INF-α)的影响。方法将68例重型颅脑外伤患者分为纤支镜治疗组(纤支镜组)和对照组,对支气管肺灌洗液做细胞学检查,同时应用放射免疫测定(RIA)法测定IL-8、TNF-α水平。结果纤支镜治疗组与对照组相比,肺灌洗液中细胞总数在治疗第7、9天显著降低(均P<0.01);中性粒细胞在第5、7、9天显著降低(均P<0.01);IL-8在第5、7、9天显著降低(均P<0.01);TNF-α在第5、7、9天显著降低(均P<0.01);IL-8、TNF-α水平与支气管肺泡灌洗液(BALF)细胞总数、中性粒细胞均成正相关(均P<0.01)。结论应用床边纤支镜对重型颅脑外伤患者进行支气管肺泡灌洗术治疗,能够改善气道的炎症状态;IL-8、TNF-α联合检测能准确反映气道的炎症状况。Objective To investigate variations of cytology,IL-8 and TNF-α of bronchoalveolar lavage fluid （BALF） after fiberoptic bronchoscopy （FOB） in patients with severe traumatic brain injury. Methods Sixty-eight patients with severe traumatic brain injury were divided into two groups., the FOB group and the control group. Variations of cytology in BALF were observed by microscope, and the levels of IL-8 and TNF-α were analyzed by radioimmunoassay （RIA）. Results Compared with the control group, the counts of cells of BALF were significantly lower at the 7th and 9th day after treatment in the FOB group（P 〈 0.01, respectively）; the percentage of polymorphonuclear neutrophils（PMN） were signifi- cantly lower at the 5th, 7th, 9th day in the FOB group（P〈 0.01, respectively）; the level of IL-8 was significantly lower at the 5th, 7th, 9th day in the FOB group （P 〈 0.01, respectively）; the level of TNF-α was significantly lower at the 5th, 7th, 9th day in the FOB group （P 〈 0.01, respectively）. Moreover, the level of IL-8 was positively correlated with the count of cells and the percentage of PMN of BALF （r= 0.979, 0.982,P 〈 0.01, respectively ）, and the level of TNF-α was also positively correlated with the count of cells and the percentage of PMN of BALF （r=0.953, 0.949,P 〈 0.01, respectively）. Conclusion FOB could play an important role in ameliorating traumatic brain injury., moreover, the level of IL-8 airway. the inflammation of airway in the patients with severe and TNF-α could reflect the status of inflammation ofairway.

关 键 词：颅脑外伤 纤支镜 支气管肺灌洗液 细胞学IL-8 TNF-α 

分 类 号：R135.2[医药卫生—劳动卫生] R587.1[医药卫生—公共卫生与预防医学]