脑出血患者脑脊液中IL-6、TNF-α含量与脑水肿、神经损害程度的相关性研究  

Correlation between IL-6 and TNF-α levels in cerebrospinal fluid with the degree of brain edema and nerve damage in patients with cerebral hemorrhage

作　　者：朱辉[1] 许超[1] 邢明尧[1] 李伯恩[1] ZHU Hui;XU Chao;XING Mingyao;LI Boen(Department of ICU,Bengbu Medi-cal College Second Affiliated Hospital,Chengdu 233000,China)

机构地区：[1]蚌埠医学院第二附属医院重症医学科,233000

出　　处：《疑难病杂志》2018年第12期1316-1319,共4页Chinese Journal of Difficult and Complicated Cases

基　　金：安徽省高等学校自然科学基金(KJ2015B122by)

摘　　要：目的分析脑出血患者脑脊液中白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)含量与脑水肿、神经损害程度的相关性。方法选择2015年12月—2017年12月蚌埠医学院第二附属医院收治的脑出血患者48例作为脑出血组,同期进行蛛网膜下腔神经阻滞下骨折内固定物取出术/骨折切开内固定术且无神经系统疾病的患者50例作为对照组。测定2组患者脑脊液中IL-6、TNF-α的含量以及血清中神经损伤标志物、氧自由基生成指标的含量,测定脑出血患者脑水肿量。结果脑出血组患者脑脊液IL-6、TNF-α的含量明显高于对照组(t/P=32. 138/0. 000、26. 335/0. 000);脑水肿CT评估量呈逐步升高趋势且(第7天)与脑脊液IL-6、TNF-α含量呈正相关(r/P=0. 581/0. 013、0. 631/0. 007);血清NSE、S100B、MDA、NO含量明显高于对照组(t/P=50. 198/0. 000、38. 887/0. 000、34. 809/0. 000、33. 064/0. 000),且与脑脊液IL-6、TNF-α含量呈正相关(r/P=0. 527/0. 023、0. 615/0. 009、0. 594/0. 011、0. 495/0. 024; 0. 568/0. 016、0. 698/0. 000、0. 577/0. 017、0. 511/0. 020),BDNF、T-AOC含量明显低于对照组(t/P=29. 028/0. 000、21. 284/0. 000),且与脑脊液中IL-6、TNF-α含量呈负相关(r/P=-0. 647/0. 007;-0. 547/0. 019、-0. 597/0. 011、-0. 633/0. 002)。结论脑出血患者脑脊液IL-6、TNF-α含量的增多与脑水肿及神经损害程度直接相关。Objective To study the correlation between the levels of interleukin 6 (IL-6) and tumor necrosis factorα (TNF-α) in cerebrospinal fluid (CSF) with the degree of cerebral edema and nerve damage in patients with cerebral hemorrhage. Methods The patients with cerebral hemorrhage admitted in our hospital during December 2015 to December 2017 were selected as the cerebral hemorrhage group,and the patients without neurological diseases who underwent joint replacement under spinal anesthesia operation at the same time were selected as the control group. The levels of IL-6 and TNF-α in cerebrospinal fluid,the levels of nerve injury markers and oxygen free radical production index in serum were measured,and the cerebral edema in patients with cerebral hemorrhage was measured. Results The levels of IL-6 and TNF-α in cerebrospinal fluid of cerebral hemorrhage group were significantly higher than those of the control group (t/P = 32. 138/0. 000,t/P =26. 335/0. 000),and the CT evaluation of cerebral edema in the patients with cerebral hemorrhage showed a gradual increasing trend and (the 7 th day) was positively correlated with the contents of IL-6 and TNF-α in cerebrospinal fluid (r/P =0. 581/0. 013,r/P = 0. 631/0. 007). The serum levels of NSE,S100 B,MDA and NO in cerebral hemorrhage group were significantly higher than those in the control group (t/P = 50. 198/0. 000,t/P = 38. 887/0. 000,t/P = 34. 809/0. 000,t/P =33. 064/0. 000) and positively correlated with the levels of IL-6,TNF-α in the CSF (r/P = 0. 527/0. 023,r/P = 0. 615/0. 009,r/P = 0. 594/0. 011,r/P = 0. 495/0. 024,r/P = 0. 568/0. 016,r/P = 0. 698/0. 000,r/P = 0. 577/0. 017,r/P =0. 511/0. 020) the levels of BDNF and T-AOC were significantly lower than those in the control group (t/P = 29. 028/0. 000,r/P = 21. 284/0. 000) and were negatively correlated with the levels of IL-6 and TNF-α in CSF (r/P =-0. 647/0. 007,r/P =0. 547/0. 019,r/P =-0. 597/0. 011,r/P =-0. 633/0. 002). Conclusion The increase of IL-6 and TNF-α in cerebrospinal fluid of patients with cer

关 键 词：脑出血 脑水肿 白细胞介素-6 肿瘤坏死因子-Α 神经损害程度 

分 类 号：R743.34[医药卫生—神经病学与精神病学]