脑出血破入脑室患者血清IL-1β、IL-6动态变化及与脑循环动力学指标的关系  

Dynamics of concentration changes for IL-1β,IL-6 and their relations with CVDI indexes in patients with intraventricular hemorrhage secondary to cerebral hemorrhage

作　　者：袁州[1] 张一凡[2] 

机构地区：[1]上海中医药大学附属曙光医院松江分院,上海201600 [2]上海市交通大学附属第一人民医院松江分院,上海201600

出　　处：《中国实用神经疾病杂志》2011年第5期5-8,共4页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨脑出血破入脑室患者血清中白细胞介素1β(IL-1β)、白细胞介素6(IL-6)动态变化及其与脑循环动力学指标及病情的关系。方法采用双抗体夹心法测定32例脑出血破入脑室患者出血后24 h、72 h、7 d和14 d时的血清IL-1β、IL-6水平,并与40例健康体检者进行对照;测量相应时间的脑循环动力学指标;患者入院时进行格拉斯哥昏迷评分(GCS)。结果患者血清IL-6在各时间点上均增高,在发病24 h时即达高峰,14 d水平与对照组比较仍高。患者各时间点IL-1β较对照组均高,峰值时间约在第7天。患者脑循环动力学检查(CVDI)发现血管阻力(R)及临界压力(CP)变化较大,在第7天到达峰值,其后下降。以GCS评分分成轻、中、重3组,IL-6及IL-1β在轻组和重组间有明显差异(P<0.05及P<0.01),重组高;患者血清IL-1β、IL-6水平与GCS呈负相关,与入院第7天脑循环动力学检查中患侧R及CP呈正相关,与第7天患侧平均血流量(Qmean)负相关。结论脑出血破入脑室患者血清IL-1β、IL-6水平增高可提示病情严重程度,并对可能发生的继发性脑血管痉挛和脑的缺血性损害有提示意义。Objective To study the dynamics of concentration changes for interleukin-1β（IL-1β）,interleukin-6（IL-6） and their relations with CVDI indexes in patients with intraventricular hemorrhage secondary to cerebral hemorrhage.Methods Serum levels of interleukin-1β and interleukin-6 were measured with the enzyme-linked immunosorbent assay（ELISA） in 32 patients with intraventricular hemorrhage secondary to cerebral hemorrhage（at 24th hour,72nd hour,7th day and 14th day after the onset） and in 40 healthy subjects（control group）.Neurological deficit was assessed on admission with the use of the Glasgow Coma Scale.CVDI indexes of all patients were acquired at the same time of ILs level assessments.Results Compared to the control group,interleukin-6 level increased in all patients at different times.It reached to a maximal level at 24 hours and gradually decreased afterwards.Interleukin-1β reached to a maximal level at 7th day while stayed high at different times.There was a significant difference between the interleukin-6 and interleukin-1β levels of the mild group and the severe group（Based on the GCS patients were divided into the mild group,the moderate group and the severe group）.Interleukin-6 and interleukin-1β levels positively correlated with Glasgow Coma Scale scores on admission and with Vmean and Qmean at 24th hour after onset.A negative correlation was found between interleukin-6 and interleukin-1β levels and R and CP at 24th hour after onset.R and CP reached to their highest levels at 7th day.Conclusion Serum levels of interleukin-1β and interleukin-6 can suggest the severity of patients with intraventricular hemorrhage secondary to cerebral hemorrhage and may give hints to the possible delayed vessel vasospasm and delayed ischemic neurological deficits.

关 键 词：脑出血 继发脑室出血 白细胞介素6 白细胞介素1Β 脑循环动力学指标 

分 类 号：R743.34[医药卫生—神经病学与精神病学]