单核细胞趋化因子蛋白1、白细胞介素-6、肿瘤坏死因子α与尿毒症性脑病预后的相关性及预测价值  

The correlation and predictive value of MCP-1,IL-6and TNF-αwith prognosis of uremic encephalopathy

作　　者：龚广欣 杨坷 赵里曼 GONG Guang-xin;YANG Ke;ZHAO Li-man(Blood Purification Room,Xuchang Central Hospital,Xuchang,Henan 461000,China)

机构地区：[1]许昌市中心医院血液净化室,河南许昌461000

出　　处：《中国卫生检验杂志》2020年第17期2141-2143,2147,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨尿毒症性脑病患者单核细胞趋化因子蛋白1(MCP-1)、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)水平及意义。方法选取2017年1月-2019年1月在本院治疗的尿毒症性脑病患者80例(观察组),同时选取尿毒症患者160例作为对照组,比较2组临床资料差异,检测脑脊液MCP-1、IL-6、TNF-α水平。结果观察组定期血滤或灌流比例明显低于对照组(P<0.05),而合并感染、抗生素使用、血钾<3.5 mmol/L、二氧化碳结合力<10 mmol/L和血肌酐>1000μmol/L比例明显高于对照组(P<0.05);Logistic回归分析结果显示:定期血滤或灌流、感染、抗生素使用和血钾<3.5 mmol/L是尿毒症性脑病的影响因素(OR值分别为0.701、2.252、2.467和2.413,P<0.05);观察组脑脊液MCP-1、IL-6和TNF-α明显高于对照组(P<0.05);观察组死亡患者脑脊液MCP-1、IL-6和TNF-α明显高于存活患者(P<0.05);脑脊液MCP-1、IL-6和TNF-α判断尿毒症性脑病预后的ROC曲线下面积分别为0.643、0.738和0.759(P<0.05)。结论尿毒症性脑病发生受多种因素影响,患者脑脊液MCP-1、IL-6和TNF-α水平明显升高,在预测患者预后方面有一定价值。Objective To investigate the levels and significance of monocyte chemokine protein-1(MCP-1),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in patients with uremic encephalopathy.Methods Eighty patients with uremic encephalopathy(observation group)who were in our hospital from January 2017 to January 2019 were selected,and 160 patients with uremia were selected as control group;the differences of clinical data between the two groups were compared,and the levels of MCP-1,IL-6 and TNF-αin cerebrospinal fluid were detected.Results The proportion of regular hemofiltration or perfusion in the observation group was significantly lower than that in the control group(P<0.05),while the proportion of combined infection,antibiotic use,blood potassium<3.5 mmol/L,carbon dioxide binding force<10 mmol/L and creatinine>1000μmol/L were significantly higher than those in the control group(P<0.05);Logistic regression analysis showed that regular hemofiltration or perfusion,infection,antibiotic use and blood potassium<3.5 mmol/L were the influencing factors of uremic encephalopathy(OR=0.701,OR=2.252,OR=2.467,OR=2.413,P<0.05);the cerebrospinal fluid MCP-1,IL-6 and TNF-αin the observation group were significantly higher than those in the control group(P<0.05);the cerebrospinal fluid MCP-1,IL-6 and TNF-αof the dead patients in the observation group were significantly higher than those of the survivors(P<0.05);the areas under the ROC curve of cerebrospinal fluid MCP-1,IL-6 and TNF-αto judge the prognosis of uremic encephalopathy were 0.643,0.738 and 0.759(P<0.05).Conclusion The occurrence of uremic encephalopathy are influenced by many factors,the levels of MCP-1,IL-6 and TNF-αin cerebrospinal fluid of patients significantly increase,which has a certain value in predicting the prognosis of patients.

关 键 词：尿毒症性脑病 单核细胞趋化因子蛋白1 白细胞介素-6 肿瘤坏死因子Α 

分 类 号：R747.9[医药卫生—神经病学与精神病学]