脑脊液引流对颅脑创伤后免疫损伤的影响  

Effects of Cerebrospinal Fluid Drainage on Changes of Antibrain-Antibody and Interleukin-1β in Rabbits with Traumatic Brain Injury

作　　者：张洪伟[1] 闫华[2] 武俏丽[2] 张国斌[2] 刘暌[2] 只达石[2] 

机构地区：[1]天津医科大学第二医院神经外科,300211 [2]天津市环湖医院神经外科

出　　处：《天津医药》2012年第1期57-59,共3页Tianjin Medical Journal

基　　金：天津市科技计划项目(项目编号:08ZCGYSF01600);天津市卫生局攻关课题(项目编号:07KG3和10KG208);天津市卫生局面上项目(项目编号:09KY17);天津市环湖医院科技基金项目(项目编号:08HHKY03)

摘　　要：目的:探讨脑脊液引流对颅脑创伤后血清抗脑抗体及白细胞介素(IL)-1β水平的影响。方法:32只大白兔随机分为对照组和脑脊液引流组(引流组),每组16只。脑损伤后0～7d每天取患兔脑脊液1mL,对照组将脑脊液回注入脑池;引流组弃去脑脊液。2组均于创伤后第1、3、7、14、21天取血2mL,分离血清,采用酶联免疫吸附试验(ELISA)检测IL-1β和抗脑抗体(ABAb)水平。结果:创伤后对照组ABAb水平逐渐增高,第14天达高峰,之后下降;引流组伤后第1天ABAb水平最高,之后逐渐降低。除第1天外,其他各时点的ABAb水平引流组均低于对照组(P<0.01)。2组创伤后IL-1β水平第1天均最高,之后逐渐降低。除第1天外,其他各时点的IL-1β水平引流组均低于对照组(P<0.05)。引流组好转率高于对照组,病死率低于对照组,差异有统计学意义(P<0.05)。结论:脑脊液引流可以减少脑组织周围的炎性因子,从而减轻颅脑创伤后的免疫损伤。Objective：To study the protective effect of cerebrospinal fluid drainage therapy on immune injury in rabbit traumatic brain injury（TBI）models.Methods：Thirty-two rabbits were randomly divided into two groups including 16 in control group and 16 in cerebrospinal fluid（CSF） drained group.From 0 d-7 d,rabbits in control group were drained CSF and injected back into cistern,and rabbits in CSF drained group were drained CSF only.Blood samples of 2 mL were collected at 1 d,3 d,7 d,14 d and 21 d after TBI in two groups.The levels of interleukin（IL）-1β and anti-brain tissue antibody（ABAb） were detected by ELISA.Results：The level of ABAb was gradually increased and reached the peak level on 14 day,and then decreased after TBI in control group.The level of ABAb was the highest on the first day and then gradually decreased in CSF drained group.In addition to the first day,levels of ABAb were lower in CSF drained group than those in control group（P 0.01）.Levels of IL-1β reached the peak level on the first day and then gradually decreased after TBI in both groups.In addition to the first day,levels of IL-1β were lower in CSF drained group than those in control group（P 0.05）.The improvement rate was higher and the mortality rate was lower in CSF drained group than those of control group（P 0.05）.Conclusion：The drainage of cerebrospinal fluid can help to decrease levels of inflammatory factors,which showed the protective effect on immunologic injury after traumatic brain injury.

关 键 词：颅脑损伤 脑脊髓液分流术 抗脑抗体 白细胞介素1Β 兔 

分 类 号：R651.11[医药卫生—外科学]