TNF-α、IL-1β和IL-6对机械通气患者ICU获得性肌无力诊断和预后的意义  

The significance of TNF-α,IL-1β,and IL-6 in the diagnosis and prognosis of patients with ICU-acquired weakness undergoing mechanical ventilation

作　　者：邓茂林[1] 杨卓[2] 邓湘辉[1] DENG Mao-Lin;YANG Zhuo;DENG Xiang-Hui(Department of Critical Medicine,Changsha Central Hospital,Changsha,Hunan 410004,China)

机构地区：[1]长沙市中心医院重症医学科,湖南长沙410004 [2]长沙市妇幼保健院眼科,湖南长沙410000

出　　处：《国际神经病学神经外科学杂志》2020年第2期157-161,共5页Journal of International Neurology and Neurosurgery

摘　　要：目的探讨肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)和IL-6在评估机械通气患者ICU获得性肌无力(ICUAW)诊断和预后中的作用。方法将2017年7月至2019年6月入住本院重症医学科患者(75例),分为观察组(47例)、对照组(28例)。观察组又分为ICUAW治愈组和ICUAW未愈组。分别在机械通气后第3天、机械通气后第10天行神经电生理检查,监测TNF-α、IL-1β、IL-6表达水平,分析TNF-α、IL-1β和IL-6对机械通气患者ICU获得性肌无力诊断和预后的作用。结果观察组与对照组在机械通气第3天、机械通气后第10天TNF-α、IL-1β、IL-6表达水平比较,观察组明显高于对照组(P <0. 05)。ICUAW未愈组与ICUAW痊愈组在机械通气后第10天TNF-α、IL-1β、IL-6表达水平比较,ICUAW未愈组明显高于ICUAW痊愈组(P <0. 05)。机械通气第3天危重症多发性神经病(CIP)、危重症肌病(CIM)、危重症肌肉神经病(CIMN)之间TNF-α、IL-1β、IL-6表达水平比较,差异无统计学意义(P> 0. 05)。结论 TNF-α、IL-1β和IL-6与ICU获得性肌无力发病存在相关性,机械通气患者持续TNF-α、IL-1β和IL-6水平增高,提示预后不良。Objective To investigate the roles of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and interleukin-6(IL-6)in the diagnosis and prognosis of intensive care unit-acquired weakness(ICUAW)in patients undergoing mechanical ventilation.Methods Seventy-five patients who were admitted to the department of critical care medicine in our hospital from July 2017 to June 2019 were divided into observation group(47 patients)and control group(28 patients).The observation group was subdivided into ICUAW cured group and ICUAW uncured group.Neuroelectrophysiological examinations were performed on the 3rd and 10th days after mechanical ventilation.The expression levels of TNF-α,IL-1β,and IL-6 were monitored,and their roles in the diagnosis and prognosis of ICUAW in patients undergoing mechanical ventilation were analyzed.Results The expression levels of TNF-α,IL-1β,and IL-6 on the 3rd and 10th days after mechanical ventilation in the observation group were significantly higher than those in the control group(P<0.05),and the expression levels of TNF-α,IL-1β,and IL-6 on the 10th day after mechanical ventilation in the ICUAW uncured group were significantly higher than those in the ICUAW cured group(P<0.05).There were no significant differences in the expression levels of TNF-α,IL-1β,and IL-6 on the 3rd day after mechanical ventilation between patients with critical illness polyneuropathy,critical illness myopathy,and critical illness myoneuropathy(P>0.05).Conclusions TNF-α,IL-1β,and IL-6 are associated with the development of ICUAW.Continuously increased TNF-α,IL-1β,and IL-6 suggest a poor prognosis in patients undergoing mechanical ventilation.

关 键 词：ICU获得性肌无力 肿瘤坏死因子-α 白介素-1Β 白介素-6 

分 类 号：R746.9[医药卫生—神经病学与精神病学]