脑出血患者血清中IL-6和TNF-α水平与患者神经功能及脑水肿体积的关系  

Relationship between serum IL-6 and TNF-α levels and neurological function and volume of cerebral edema in patients with intracerebral hemorrhage

作　　者：廖鹏[1] 耿保伟[1] 张小翠[2] 余政[1] 王剑波[1] 田劲[1] 邓超[1] 张入丹[1] Liao Peng;Geng Baowei;Zhang Xiaocui(Department of Neurosurgery,Fuling Central Hospital of Chongqing,Chongqing 408099,China)

机构地区：[1]重庆市涪陵中心医院神经外科,408099 [2]重庆市涪陵中心医院肾内科,408099

出　　处：《中华保健医学杂志》2018年第5期406-408,共3页Chinese Journal of Health Care and Medicine

基　　金：重庆市涪陵区卫计委医学重点学科建设项目(NO.2015MSXM139)

摘　　要：目的研究脑出血患者血清中白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平与患者神经功能及脑水肿体积的关系。方法选择2016年11月～2017年11月重庆市涪陵中心医院收治的90例脑出血患者,所有患者均采用酶联免疫吸附法检测患者血清中IL-6和TNF-α水平,采用NIHSS评分评价患者神经功能,头颅CT测定患者脑水肿体积,探讨患者血清中IL-6和TNF-α水平与患者神经功能及脑水肿体积的关系,并采用logistics回归分析探讨血清中IL-6和TNF-α水平与患者临床预后的关系。结果 TNF-α低水平患者治疗后7、14 d神经功能评分为(8.6±1.2)、(6.9±2.2)分,明显低于TNF-α高水平的患者;IL-6低水平的患者治疗后7、14 d神经功能评分为(8.9±1.2)、(6.5±1.6)分,明显低于IL-6高水平的患者,差异均有统计学意义(P <0.05)。TNF-α低水平患者治疗后7、14 d脑水肿体积为(21.6±3.5)、(9.8±1.9)分,明显低于TNF-α高水平的患者;IL-6低水平的患者治疗后7、14 d脑水肿体积为(22.3±2.6)、(8.9±2.4)分,明显低于IL-6高水平的患者,差异均有统计学意义(P <0.05)。TNF-α(P=0.012)、脑水肿体积(P=0.020)、IL-6(P=0.040)、出血量(P=0.008)、手术效果(P=0.010)是脑出血患者预后不良的独立风险因素。结论脑出血患者血清中IL-6、TNF-α水平是患者预后不良的独立危险因素。Objective To study the relationship between serum -α levels and ne urological function and cerebral edema volume in patients with intracerebral hemorrhage. Methods 90 patients with cerebral hemorrhage admitted in our hospital during the period of November,2016-November 2017, were selected as the subjects. All the patients were detected by enzyme linked immunosorbent assay （ELISA）and the level of IL-6 and TNF-α in the patients＇ serum. The NIHSS score was used to evaluate the patient＇s nerve function. The volume of brain edema in the patients was measured by CT,and the level of IL-6 and TNF-α in the patient＇s serum and the volume of neurologic and brain edema in the patients were discussed. Logistics regression analysis was used to investigate the relationship between serum IL-6 and TNF-α levels and clinical prognosis. Results The neural function scores in the patients with low level TNF-α on 7d and 14d after treatment were 8.6 ±1.2 and 6.9 ± 2.2, and those were significantly lower than the scores in the patients with high level TNF-α. The neural function scores in the patients with low level IL-6 patients were 8.9 ± 1.2 and 6.5 ± 1.6 respectively, those were lower than the scores in the patients with t high level IL-6 on 7d and 14d after treatment The volume of cerebral edema on 7d and 14d after the treatment in the patients with the low level TNF-α were 14. 21.6± 3.5 and 9.8 ± 1.9, also the data were significantly lower than those in the patients with high INF- a level. The cerebral edema volume of patients with low level of IL-6 were 22.3 ± 2.6,8.9 ±2.4 were significantly lower than those of the patients with high IL-6 level. TNF-α （P=0.012）,cerebral edema volume （P=0.02）,IL-6 （P=0.04）,bleeding Volume （P=0.008）,surgical Effect（P=0.010） were independent risk factors for poor prognosis in patients with cerebral hemorrhage. Conclusion serum IL-6 and TNF-α levels are independent risk factors of poor prognosis in patients with intracerebral hemorrhage.

关 键 词：脑出血 白介素-6 脑水肿 肿瘤坏死因子-Α 

分 类 号：R743.34[医药卫生—神经病学与精神病学]