急性脑损伤患者血清TNF-α、IL-6、IL-8、全血hs-CRP、CD3^＋／HLA-DR^＋水平的变化及临床意义  

Changes of serum TNF-a, IL-6, IL-8, whole blood hs-CRP and CD3^＋/HLA-DR^＋ levels in patients with acute brain injury and their clinical significance

作　　者：李舟[1] 王笑颜[1] 顾金华[1] 

机构地区：[1]湖州市中心医院检验科,浙江湖州313000

出　　处：《浙江医学》2009年第9期1222-1225,共4页Zhejiang Medical Journal

摘　　要：目的动态监测急性脑损伤患者血清肿瘤坏死因子-a（TNF-a）、白介素-6（IL-6）、白介素-8（IL-8）及全血超敏C-反应蛋白（hs-CRP）、CD3^＋／HLA-DR^＋水平的变化，为临床提供脑组织损伤严重程度的参考及评价预后方法将126例急性脑损伤患者分为4组（轻型组、中型组、重型组、特重型组），监测不同时间段（〈12h、24h及第3、5、7天）TNF-a、IL-6、IL-8、hs-CRP、CD3^＋／HLA-DR^＋的水平并进行比较分析。结果4组患者伤后12h内TNF-a、IL-6、IL-8、hs-CRP、CD3^＋／HLA-DR^＋水平均升高，TNF-a、IL-6、IL-8水平在伤后第3天达到高峰，轻型组、中型组、重型组上述指标水平均持续下降，而特重型组伤后第7天仍保持较高的水平（P〈0.05）。TNF-a、IL-6、IL-8水平升高与颅脑损伤程度呈正相关（P〈0.05）。TNF-a、IL-6、IL-8、CD3^＋／HLA-DR^＋水平升高又与hs-CRP呈正相关（P〈0.01）。结论脑损伤患者体内存在不同程度的炎症和免疫反应。脑损伤急性期，炎性反应因子TNF-a、IL-6、IL-8、hs-CRP及血管损伤的细胞因子CD3^＋／HLA-DR^＋表达与血肿的扩大密切相关，各类参与炎性反应的因子相互促进和调节，动态监测有助于早期判断脑损伤的严重程度和预后评估。Objective To investigate changes of serum tumor necrosis factor-a （TNF-a）, interleukin-6（IL-6）, IL-8 （IL-8）, whole blood ultra-sensitive C-reactive protein （hs-CRP）, CD3^＋/HLA-DR^＋ in patients with acute brain injury. Methods One hundred and twenty six patients with acute brain injury were divided into 4 groups： mild, intermediate, severe and very severe groups. Serum TNF-a, IL-6, IL-8, whole blood hs-CRP and CD3^＋/HLA-DR^＋ were measured at different time points （in 12h, 1d, 3d, 5d and 7d）. Results Serum TNF-a, IL-6, IL-8, whole blood hs-CRP, CD3^＋/HLA-DR^＋ concentrations were increased in all patients at 12h after injury and reached the peak in 3d, then gradually decreased except those in very severe group, which maintained at high levels in 7d. Serum levels of TNF-a, IL-6, IL-8 were positively correlated with the severity of brain injury （P〈 0.05）; and Ⅱ-6 and hs-ORP, hs-CRP and CO3^＋/HLA-DR^＋ levels were positively correlated with hs-CRP （P 〈 0.01） . Conclusion Serum TNF-a, IL-6, IL-8, hs-CRP and CD3^＋/HLA-DR^＋ are closely related to the severity of acute brain injury, which can be used to monitor the extent of brain injury and prognosis of patients.

关 键 词：脑损伤TNF-a IL-6 IL-8 HS-CRP CD3^+/HLA-DR^+ 

分 类 号：R556.5[医药卫生—血液循环系统疾病] R725.6[医药卫生—内科学]