颈部脊髓损伤患者24h内外周血中细胞因子水平与ASIA功能分级的相关性:对照组比较  

Correlation of cytokine levels in the peripheral blood within 24 hours after cervical spinal cord injury with the American Spinal Injury Association impairment scale: a comparative study

作　　者：张勇[1] 申才良[1] 董福龙[1] 章仁杰[1] 葛鹏[1] Zhang Yong;Shen Cai-liang;Dong Fu-long;Zhang Ren-jie;Ge Peng(Department of Spinal Surgery,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,Anhui Province,China)

机构地区：[1]安徽医科大学第一附属医院脊柱外科,安徽省合肥市230022

出　　处：《中国组织工程研究》2018年第24期3824-3830,共7页Chinese Journal of Tissue Engineering Research

基　　金：安徽医科大学第一附属医院骨科及相关部门的支持;安徽医科大学基础医学院免疫教研室和实验室的支持与帮助

摘　　要：背景:研究表明细胞因子在脊髓损伤的病理生理机制中发挥着至关重要的作用。直接或者间接的抑制或者减轻脊髓损伤后免疫炎性反应,能够改善患者的预后以及神经功能的恢复。目的:分析颈部脊髓损伤早期(<24 h)患者外周血中的白介素1β、白细胞介素6、白细胞介素10、肿瘤坏死因子α、转化生长因子β1和干扰素γ水平的变化与ASIA神经功能分级的相关性,并探讨细胞因子介导的免疫炎症反应在颈部脊髓损伤发病机制中的作用。方法:30例颈部脊髓损伤患者为脊髓损伤组,另外20例健康的血液捐献者为对照组。采集外周静脉血,并使用酶联免疫吸附(ELISA法)测定外周血中细胞因子水平。脊髓损伤组依据ASIA分级分成A级10例为完全性脊髓损伤组,B级+C级+D级+E级20例为不完全性脊髓损伤组。结果与结论:(1)脊髓损伤组外周血中白细胞介素1β、白细胞介素6和转化生长因子β1水平均明显高于对照组;(2)颈部脊髓损伤患者中完全性脊髓损伤组外周血中转化生长因子β1水平明显高于不完全性脊髓损伤组(P<0.01);(3)结果说明,颈部脊髓损伤早期患者外周血中白细胞介素1β、白细胞介素6和转化生长因子β1的水平升高;颈部脊髓损伤患者外周血中转化生长因子β1水平与脊髓受损的严重程度有相关性,提示颈部脊髓损伤后患者神经系统功能缺失的程度与免疫反应之间存在着一定的联系。BACKGROUND： Cytokines play a critical role in the pathophysiologic mechanism of spinal cord injury（SCI）. Direct or indirect inhibition or alleviation of immune inflammatory reactions following SCI can improve the patient＇s prognosis and recovery of neurologic function. OBJECTIVE： To investigate the correlation between the levels of interleukin-1β, interleukin-6, interleukin-10, tumor necrosis factor-α, transforming growth factor-β1 and interferon-γ in the peripheral blood of patients with early cervical SCI and the American Spinal Injury Association（ASIA） impairment scale, and explore the role of cytokine-mediated immune inflammatory responses in the pathogenesis of cervical SCI. METHODS： Thirty patients with cervical SCI and 20 healthy controls were enrolled. The levels of related cytokines in the peripheral blood were detected by ELISA. According to the ASIA impairment scale, all patients were divided into two groups： complete SCI group（Grade A, 10 cases） and incomplete SCI group（Grade B＋C＋D＋E, 20 cases）. RESULTS AND CONCLUSION： The levels of interleukin-1β, interleukin-6 and transforming growth factor-β1 in the peripheral blood in the SCI patients were significantly higher than those in the control group. The level of transforming growth factor-β1 in the peripheral blood of the complete SCI patients was significantly higher than that of incomplete SCI patients. Our findings imply that the levels of interleukin-1β, interleukin-6 and transforming growth factor-β1 in the peripheral blood of patients with cervical SCI in early period are increased significantly, and the level of transforming growth factor-β1 is associated with the severity of SCI, suggesting that there is a correlation between dysfunction of nervous system and immune response post-cervical SCI.

关 键 词：颈部脊髓损伤 ASIA分级 神经功能 细胞因子 白细胞介素1Β 白细胞介素6 转化生长因子Β1 组织构建 

分 类 号：R318[医药卫生—生物医学工程]