脑外伤患者血清IL-8和TNF-α表达与颅内压的关系  

Relationship of serum IL-8 and TNF-α expressions and intracranial pressure in patients with traumatic brain injury

作　　者：蒋文庆[1] 卞晓星[1] 金鹏[1] 魏文峰[1] 陈红春[1] 

机构地区：[1]常州市武进人民医院神经外科,江苏省213017

出　　处：《江苏医药》2017年第4期241-244,共4页Jiangsu Medical Journal

基　　金：常州市武进区科研基金(WS201406)

摘　　要：目的研究重型脑外伤患者血清IL-8和TNF-α表达与术后颅内压(ICP)之间的关系。方法重型脑外伤手术患者29例。术中放置颅内测压导管监测ICP;术后每12小时记录ICP,采用ELISA法检测血清IL-8和TNF-α水平,分析血清IL-8和TNF-α水平与患者预后的关系。结果患者术后血清IL-8及TNF-α水平与ICP均呈正相关(P<0.01)。患者获6~17(8.2±5.3)个月随访。术后6个月格拉斯哥预后扩展量表(GOSE)评分(4.0±2.4)分,死亡7例(24.1%)。29例中,预后良好13例(44.8%),血清IL-8为20.3(12.6,30.7)pg/ml;TNF-α为4.7(2.5,8.6)pg/ml;预后不良16例(55.2%),血清IL-8为77.2(29.5,144.6)pg/ml,TNF-α为10.1(5.7,19.2)pg/ml;预后良好患者血清IL-8和TNF-α水平低于预后不良患者(P<0.01)。结论血清IL-8和TNF-α水平可反映脑外伤患者术后ICP变化,对判断患者病情和预后有重要意义。Objective To investigate the relationship of serum IL-8and TNF-αexpressions and intracranial pressure（ICP）in the patients with severe traumatic brain injury（TBI）.Methods ICP after surgery was monitored in 29 patients with severe TBI.Serum expressions of IL-8and TNF-αwere detected by ELISA every 12 hours after surgery.The relationship of serum IL-8 and TNF-αexpressions and ICP was analyzed.Results Serum expressions of IL-8and TNF-αafter surgery were positively correlated with ICP（P〈0.01）.The patients were followed up for 6-17（8.2±5.3）months,which showed that 7cases died and Glasgow prognostic extension scale（GOSE）score of survival cases was（4.0±2.4）points in the 6^th month after operation.Serum expressions of IL-8and TNF-αafter surgery were lower in 13 cases with good prognosis（GOSE 5-8points）than those in 16 cases with poor prognosis（GOSE 1-4points）[（20.3pg/ml vs.77.2pg/ml）and（4.7pg/ml vs.10.1pg/ml）]（P〈0.01）.Conclusion Serum expressions of IL-8and TNF-αafter surgery may reflect the changes of ICP and are helpful in evaluating illness state and prognosis of patients with severe TBI.

关 键 词：白细胞介素8 肿瘤坏死因子α 脑外伤 颅内压 

分 类 号：R651[医药卫生—外科学]