急性脑出血患者血清炎性因子和CRP的动态变化及其意义  

Dynamic Changes of Serum Inflammatory Factors and C Reactive Protein Levels in Patients with Acute Cerebral Hemorrhage

作　　者：童海燕 程华丽[2] 

机构地区：[1]重庆市万盛区南桐矿业公司总医院,重庆400800 [2]湖北医药学院附属人民医院,湖北十堰442000

出　　处：《医学临床研究》2016年第9期1718-1720,1724,共4页Journal of Clinical Research

摘　　要：[目的]探讨急性脑出血患者血清炎症因子、C反应蛋白（CRP）水平的动态变化及其意义。[方法]选取本院2013年2月至2014年12月神经内科收治的100例高血压急性脑出血患者作为研究对象（脑出血组）、选取同期50例年龄、性别基本匹配的健康体检正常者作为对照组，对比两组的血清炎症因子水平，分析炎症因子水平与患者格拉斯哥昏迷评分（GCS）、脑水肿程度的相关性。[结果]脑出血组患者在起病后6h、24h、72h、7d和14d的白细胞介素6（IL-6）、IL-8、IL-10、肿瘤坏死因子-α（TNF-α）、CRP水平均显著的高于对照组（P〈0．05）；且IL-6在起病后72h达到最高值，后逐渐降低；其IL-8、IL-10、TNF-α、CRP水平在起病后7d达到最高值，之后逐渐降低；d14，脑出血患者GCS评分基本恢复正常水平，脑水肿量较起病12h时显著降低（P〈0．05）。脑出血组患者的IL-6水平与GCS评分、脑水肿量的相关性不具有统计学意义（P〉0．05），脑出血患者的血清IL-8、IL-10、TNF-α和CRP与GCS评分、脑水肿量均呈显著的正相关关系（P〈0．05）。[结论]外周血炎症因子IL-8、IL-10、TNF-α和CRP与GCS评分、脑水肿量具有一定的关系，这对于诊治高血压脑出血患者具有一定的指导价值。[Objective]To investigate the dynamic changes of serum inflammatory factors and C reactive protein（CRP） levels in patients with acute cerebral hemorrhage and their significance. [Methods]A total of 100 cases of acute hypertensive intracerebral hemorrhage patients admitted to the neurology department at our hospital from February 2013-December 2014 were selected as research subjects in the cerebral hemorrhage group,while a total of 50 healthy subjects of the matched age and gender in the same time period were chosen as the control group. The serum levels of inflammatory cytokines were compared and the correlation between these levels and scores on the Glasgow Coma Scale （GCS） and between the levels and the degree of cerebral edema were analyzed. [Results] The IL-6, IL-8, IL-10, TNF-α, and CRP levels of patients in the cerebral hemorrhage group 6h, 24h, 72h, 7d, and 14 d after onset of the disease were significantly higher than those of patients in the control group（ P 〈0.05） ; IL-6 was highest 72h after onset and gradually decreased after that point while IL-8, IL-10, TNF-α, and CRP levels were highest 7d after onset and gradually decreased after that point. At 14d in the cerebral hemorrhage group, GCS scores returned to normal levels and brain edema was significantly reduced compared to 12h after onset（ P〈 0.05）. The correlations between IL-6 and GCS score and between IL-6 and cerebral edema in patients of the cerebral hemorrhage group were not significant（ P 〉0.05）, while IL-8, IL-10, TNF-α, and CRP level showed significant positive correlation with GCS score and brain edema volume in the cerebral hemorrhage group（ P〈0.05）. [Conclusion] Peripheral inflammatory cytokines IL-8, IL-10, TNF-α, and CRP have a certain relationship with GCS score and volume of cerebral edema, which have a guiding value in the diagnosis and treatment of patients with cerebral hemorrhage.

关 键 词：脑出血 急性病 白细胞介素8/血液 白细胞介素10/血液 肿瘤坏死因子-α/血液 C反应蛋白质/分析 格拉斯哥昏迷量表 

分 类 号：R743.34[医药卫生—神经病学与精神病学]