颅脑损伤与血清α-黑色素细胞刺激素含量的相关研究  

The changes of orhormone in the serum of patients with TBI

作　　者：冯贵龙[1] 张强[1] 冯杰[1] 童宇平[1] 张华屏[2] 杨晓明[1] 

机构地区：[1]山西医科大学第一医院急诊科,太原030001 [2]山西医科大学基础医学部分子生物学实验室

出　　处：《中华急诊医学杂志》2016年第12期1243-1247,共5页Chinese Journal of Emergency Medicine

基　　金：山西省自然科学基金（2014011041-2）

摘　　要：目的本研究探讨颅脑损伤后血清黑色素细胞刺激素α-MSH含量变化，以及与颅脑损伤严重程度、血清肿瘤坏死因子-α（TNF-α）的关系。方法选取急性颅脑损伤患者48例，按GCS评分归为3组，重度组（3—8分）18例，中度组（9—12分）16例，及轻度组（13～15分）14例；并选取健康自愿者10例为对照组。于伤后24h内、3d、5d、7d分别抽取血标本，采用酶联免疫吸附双抗体夹心（ELISA）方法测定血清α-MSH和TNF-α的含量。数据用均数±标准差（x^-±s）表示；统计分析采用重复测量的方差分析及进一步多重比较；如需两数据之间单独比较采用LSD-t检验法；相关性分析采用Pearson相关性分析。结果各颅脑损伤组血清α-MSH含量均低于对照组（P〈0．05），且病情越重α-MSH含量越低，其最低值在第3天或第5天[重度组（9．65±4．21）pg／mL，中度组（10．69±4．30）pg／mL，轻度组（18．89±7．19）pg／mLvs．对照组（45．67±10．95）pg／mL]。各损伤组血清TNF-α含量与对照组比较均增高（P〈0．05），病情越重TNF-α含量越高，且三组均于第3天达最高[重度组（37．24±18．28）pg／mL，中度组（26．19±6．78）pg／mL，轻度组（18．60±7．83）pg／mLvs．对照组（10．74±1．71）pg／mL]。患者血清α-MSH含量和TNF-α含量在四个时间点均呈负相关。结论颅脑损伤后血清α-MSH含量降低，低点在3d或5d；血清TNF-α含量增高，峰值在3d；损伤程度越重，这些含量改变越明显；血清α-MSH和TNF-α含量基本呈负相关。Objective To study the effects of α-melanocyte-stimulating hormone （α-MSH） on excessive inflammatory response of patients to traumatic brain injury （ TBI ） so as to prevent against the development of the secondary injury by observing the changes of α- MSH level in the serum of patients with TBI, and the relationships of the levels of serum α- MSH with the severity of TBI, and with the levels of tumor necrosis factor-α （TNF-α）. Methods A total of 48 patients with acute TBI were divided into three groups according to GCS score： severe group with GCS 3- 8 （n = 18）, moderate group with GCS 9- 12 （n = 16）, and mild group with GCS 13-15 （n = 14）. Ten healthy volunteers were recmited as a control group. The blood samples were collected within 24 h and 3 d, 5 d, 7 days after injury . The concentrations of α- MSH and TNF-α in the separated serum were measured by double antibody sandwich enzyme-linked immunosorbent assay （ELISA）. All variables were presented as （ x^- ± s）. Repeated measures and analysis of variance and further multiple comparisons were carried out to compare variables. When necessary, the Student＇s t test was utilized. Pearson correlation analyses were performed to determine the correlations between variables. Results The serum α-MSH levels in the three TBI groups were lower than that in the control group （P 〈 0. 05）. And the severer injury was, the lower α-MSH level was. The lowest α-MSH levels dropped to the trough on the 3rd day or the 5th day after TBI [ severe group ： （9.65 ± 4. 21 ） pg/mL,moderate group： （10.69±4.30） pg/mL, mild group： （18.89 ±7. 19） pg/mLvs, control： （45.67 ± 10. 95） pg/mL]. While the serum TNF-α levels in three TBI groups were higher than that in the control group （ P 〈 0. 05 ）, and the TNF-α level was higher in the severer group. The peak values of TNF-α in the three TBI groups reached on the 3rd day after TBI [ severe group： （37.24 ± 18. 28） pg/mL, moderate group： （26.19±6.78）

关 键 词：颅脑损伤 Α-黑色素细胞刺激素 肿瘤坏死因子-Α 炎症 神经肽 

分 类 号：R651.15[医药卫生—外科学]