急性脊髓损伤脑脊液中炎性因子IL-6、IL-8的表达  

Expression of cerebrospinal fluid inflammatory cytokines IL-6 and IL-8 in acute spinal cord injury

作　　者：钱列[1] 劳立峰[1] 蒋恺骉 于博[1] 刘祖德[1] QIAN Lie LAO Li-feng JIANG Kai-biao YU Bo LIU Zu-de

机构地区：[1]上海交通大学医学院附属仁济医院骨科,上海200127

出　　处：《脊柱外科杂志》2016年第5期272-276,共5页Journal of Spinal Surgery

基　　金：上海市卫生局科研课题(20124358)

摘　　要：目的：了解急性脊髓损伤（SCI）后脑脊液中炎性因子白介素（IL）-6和IL-8的表达情况，探索其与SCI程度的关系。方法急性SCI患者31例，均在脊髓休克恢复后按Frankel分级进行神经功能评价，分为A级组4例、B级组7例、C级组12例、D级组8例。所有患者均在48 h内行手术减压植骨融合内固定治疗，随访6个月。在患者受伤后12、24、36、48、72 h行腰椎穿刺术并收集脑脊液，采用ELISA法检测IL-6和IL-8的浓度。结果 Frankel分级A级组1例死亡，3例神经功能无明显改善；其他组均有一定比例的患者神经功能改善。IL-6和IL-8在SCI早期（12 h）即出现高表达，且SCI越严重IL-6和IL-8升高越明显，损伤程度最严重的A级组IL-6和IL-8的表达分别为其他组的2.4-9.1倍和2.0-17.8倍；IL-6和IL-8的峰值分别在36 h和24 h；其中IL-6升高幅度更大、更持久，浓度变化大，且与SCI程度相关，损伤程度最严重的A级组IL-6在24、36、48 h的表达与12 h时的比值分别为3.6、5.6、4.7，而其他组的相应比值范围为0.74-2.40。结论急性SCI早期脑脊液中IL-6和IL-8浓度变化可在一定程度上作为判断SCI程度的指标，对帮助临床判断是否进行早期手术治疗有一定的参考价值。Objective To learn about the meaning of concentration changes in inflammatory cytokines interleukin （IL）-6 and IL-8 in cerebral spinal fluid（CSF） after acute spinal cord injury（SCI）,so as to explore the relationship between expression of these inflammatory cytokines and severity of SCI.Methods Thirty-one patients with acute SCI were graded to 4 groups according to the Frankel classification as soon as recovering from spinal shock after injury. The 4 groups included Frankel A group（n=4）,Frankel B group（n=7）,Frankel C group（n=12）,and Frankel D group（n=8）. All patients were operated within 48 h and folowed up for at least 6 months. The CSF（3 mL） of each patient was colected by lumbar puncture 12,24,36,48 and 72 h after SCI and the concentration of IL-6 and IL-8 in CSF was determined by ELISA.Results In Frankel A group,3 patients had no improvement in neural function,and the other one patient died at 10 d after injury. In the other groups there were some patients having improvement in neural function. Expression of IL-6 and IL-8 increased at 12 h after serious SCI and were proportional to the injury severity. In Frankel A group patients with the most serious SCI,the concentration of IL-6 and IL-8 were 2.4 -9.1 times and 2.0 -17.8 times the other group patients. IL-6 and IL-8 reached peak concentrations at 36 h and 24 h after injury. The increased amplitude of IL-6 was great and the ratios of IL-6 concentration at different time points to 12 h were 24 h/12 h 3.6,36 h/12 h 5.6,and 48 h/12 h 4.7 in Frankel A group. In the other groups the ratios were 0.74 -2.40 in Frankel B group,Frankel C group and Frankel D group.Conclusion The concentration of IL-6 and IL-8 early after SCI can be used as a biomarker for injury severity and can possibly guide a clinician to decide early operation.

关 键 词：脊髓损伤 白细胞介素类 白细胞增多 

分 类 号：R651.21[医药卫生—外科学]