颅脑损伤急性期血清中的炎性因子与神经功能损伤及预后关系  

Relationship between serum inflammatory factors and neurological impairment and outcome in patients with acute brain trauma

作　　者：陈郁强 谢扬[1] 韩溟[1] 张摇威 黄铿[1] 

机构地区：[1]汕头大学医学院第二附属医院急诊科,广东515041

出　　处：《创伤外科杂志》2014年第5期411-414,共4页Journal of Traumatic Surgery

基　　金：广东省科技厅计划项目(2012B031800442)

摘　　要：目的 探讨创伤性颅脑损伤（TBI）急性期患者血清中的肿瘤坏死因子-α（TNF-α）、白介素-1β（IL-1β）及超敏C反应蛋白（hsCRP）的变化规律与神经功能损伤程度和预后关系.方法 回顾性分析2012年12月～2013年9月我院收治的60例TBI患者,其中男性47例,女性13例;年龄15 ～ 82岁,平均40.9岁.60名TBI患者为研究对象,根据入院时格拉斯哥昏迷评分及伤后3个月格拉斯哥预后评分分别进行分组,17名正常健康人作为对照组,测定颅脑损伤患者第1、3、7d的血清TNF-α、IL-β水平及24h内血清中hsCRP含量.结果 颅脑损伤患者在伤后第1、3、7d血清中TNF-α水平显著高于对照组（P＜0.05）;重型组血清中TNF-α和IL-1β水平在各个时间点均明显高于轻型组（P＜0.05）;伤后24h内重型组、中型组血清中hsCRP显著高于轻型组;预后不良组第1、3、7d的血清中TNF-α水平均显著高于预后良好组（P＜0.01）;预后不良组伤后24h内血清中hsCRP显著高于预后良好组.结论 颅脑损伤所致神经系统损伤患者急性期血清中TNF-α、IL-1β及hsCRP均显著升高,且升高的程度与神经功能损伤程度及预后有密切关系.Objective To explore the relationship of serum TNF-o,IL-1 β and hsCRP with neurological impairment and outcome in patients with acute brain traumatic injury （TBI）.Methods Sixty patients with acute brain trauma from Dec.2012 to Sep.2013 in our hospital were divided into different groups based on Glasgow Coma Scale（GCS） and Glasgow Outcome Scale（GOS）.The normal control group consisted of 17 healthy people.The serum levels of TNF-α and IL-1 β were tested by ELISA double antibody on the 1 st,3rd,7th day after injury.The level of hsCRP in serum within 24 hours was detected by immunoturbidimetric assay.Results On the 1 st,3rd,7th day after injury,the serum levels of TNF-o were higher than those in the control group and the serum levels of TNF-α and IL-1 β in the severe group were higher than those in the mild group （P ＜ 0.05） ; within 24 hours,the serum levels of hsCRP in the severe group and the moderate group were higher than those in the mild group （P ＜ 0.05） ; the serum levels of TNF-α and hsCRP in the poor outcome group were higher than those in the good outcome group.Conclusion The serum levels of TNF-α,IL-1 β and hsCRP are significantly elevated and are related with the severity of neurological impairment in patients with acute brain trauma.

关 键 词：颅脑损伤 神经损伤 炎性因子 

分 类 号：R651.1[医药卫生—外科学]