TNF-α，IL-18预测急性脑血管病并发MODS的意义  

Clinical Significance of Tumor Necrosis Factor- and Interleukin-18 in the Prediction of Multiple Organ Dysfunction Syndrome after Acute Cerebrovascular Disease

作　　者：何伟[1] 谢逸群[2] 

机构地区：[1]解放军163医院神经内科,湖南长沙410003 [2]中南大学湘雅二医院老年病科,湖南长沙41001i

出　　处：《医学临床研究》2010年第9期1716-1718,共3页Journal of Clinical Research

摘　　要：[目的]探讨肿瘤坏死因子-α（TNF-α）,白介素-18（IL-18）在预测急性脑血管病并发多器官功能障碍综合征（MODS）中的意义.[方法]选择2007年12月至2008年11月在本院神经内科及神经外科住院治疗的脑血管病（ACVD）患者,共59例,分为两组：MODS组和单纯ACVD组.另选择体检中心健康受试者28例作为对照组,患者入组后第2天,清晨空腹采静脉血4 mL,在室温中放置15 min后,以12 000 r/min速度离心5 min,将离心后的上层血清收集并储存于-70℃的冰箱内.ABC-ELISA法测定血清中TNF-α、IL-18水平,并进行MODS病情分期诊断及严重程度评分标准评分.[结果]三组血清中TNF-α,IL-18含量有显著性差异,其中MODS组最高,其次为单纯ACVD组,健康对照组最低.TNF-α与MODS严重程度评分无相关性（P〈0.05）,IL-18与MODS严重程度评分呈正相关.[结论]TNF-α、IL-18可作为预测MODS发生的指标.IL-18与MODS病情严重程度密切相关,可能成为预防MODS发生的新靶点.[Objective] To explore the clinical significance of tumor necrosis factor-α（TNF-α） and Interleukin-18（IL-18） in the prediction of multiple organ dysfunction syndrome（MODS） after acute eerebrovascular disease（ACVD）. [Methods] All 59 patients in this prospective cohort study with ACVD were enrolled in the neurology department and neurosurgery department of our hospital from Dec. 2007 to Nov. Z008. All the patients were divided into the MODS group and the simple ACVD group. All 28 control samples were selected from Medical Examination Center. Venous blood 4ml was collected in the next morning after the patients enrolled, and allowed to clot at room temperature for 15min, then spun at 12,000 rmp for 5rain, and the serum was collected for storage at --70℃. Serum TNF-α and IL-18 levels were measured by ELISA. And the patients were assessed by MODS scores. [Results]The serum TNF-α and IL-18 levels in MODS group were the highest, and those in the simple ACVD group were the second, and those in the normal control group were the lowest. There was a positive correlation between the serum IL-18 and MODS scores. [ConclusionlTNF-α and IL-18 may be the markers of predicting the incidence of MODS. IL-18 is closely associated with MODS, and may be the new target for predicting the incidence of MODS .

关 键 词：脑血管意外/并发症 多器官功能衰竭 肿瘤坏死因子 白细胞介素18 

分 类 号：R743.3[医药卫生—神经病学与精神病学]