脑脊液炎性因子在早期急性蛛网膜下腔出血患者预后中的价值  

Prognostic value of csf inflammatory factors in patients with early acute subarachnoid hemorrhage

作　　者：杜家琇[1] 杨冬冬 赵萌 陈莉莉 王红宇[1] 张淑玲[1] DU Jiaxiu;YANG Dongdong;ZHAO Meng;CHEN Lili;WANG Hongyu;ZHANG Shuling(Zhengzhou People’s Hospital,Zhengzhou 450003,China)

机构地区：[1]郑州人民医院,河南郑州450003

出　　处：《中国实用神经疾病杂志》2023年第2期205-209,共5页Chinese Journal of Practical Nervous Diseases

基　　金：河南省科技攻关项目(编号:LHGJ20220785)。

摘　　要：目的 探讨急性蛛网膜下腔出血患者早期脑脊液和血清炎性因子水平,及其对预后的预测价值。方法 选取2020-05-2022-08郑州人民医院神经重症监护室收治的63例急性蛛网膜下腔出血患者为研究对象,根据出院时患者的改良Rankin评分分为预后良好组(0~3分,n=35),预后不良组(4~6分,n=28)。比较所有SAH患者脑脊液和血清炎性因子水平的差异,及预后良好组与预后不良组之间的差异,同时比较脑脊液红细胞、白细胞,血清白细胞、CRP、PCT和炎性因子的相关性,评估炎性因子对于急性蛛网膜下腔出血患者预后的预测价值。结果 与血清炎性因子相比,早期急性蛛网膜下腔出血患者脑脊液IL-2、IL-4、IL-6、IL-8、IL-10、IL-1β水平更高,差异有统计学意义(P<0.05);与预后良好组相比,预后不良组脑脊液IL-2、IL-4、IL-6、IL-10、IL-1β水平表达更高,差异有统计学意义(P<0.05);脑脊液白细胞水平和脑脊液IL-2、IL-6、IL-8、IL-10、IL-1β存在正相关。结论 脑脊液炎性因子更能反映急性蛛网膜下腔出血后免疫炎症状态,可作为急性蛛网膜下腔出血患者预后不良的标记物,为SAH患者针对脑脊液炎症级联反应的防治提供新的思路及参考。Objective To investigate the early levels of inflammatory factors in cerebrospinal fluid and plasma in patients with acute subarachnoid hemorrhage(SAH)and their prognostic value.Methods The data of 63 patients with acute subarachnoid hemorrhage admitted to our neurological intensive care unit from May 2020 to August 2022 were retrospectively analyzed.The patients were divided into good prognosis group(0-3 points,n=35)and poor prognosis group(4-6 points,n=28)according to the modified Rankin score(MRS)at discharge.Compare the difference of CSF and plasma inflammatory factor levels in all SAH patients,and the difference between the two groups.At the same time,compare the correlation between CSF red blood cells,white blood cells,plasma white blood cells,CRP,PCT and inflammatory factors,and to calculate the predictive value of CSF and plasma inflammatory factors for the prognosis of patients with acute subarachnoid hemorrhage.Results Compared with plasma inflammatory factors,The level of interleukin-2,IL-4,IL-6,IL-8,IL-10,IL-1βin CSF of patients with early acute subarachnoid hemorrhage was higher than that of plasma,Compared with the group with good prognosis,The level of CSF IL-2,IL-4,IL-6,IL-10,IL-1βwas a higher expression in the poor prognosis group(P<0.05),There was positive correlation between CSF leukocytes and inflammatory factors IL-2,IL-6,IL-8,IL-10,IL-1β.Conclusion The level of CSF inflammatory factors can better reflect the immune inflammatory state after acute subarachnoid hemorrhage,and can be used as a marker of poor prognosis in patients with acute subarachnoid hemorrhage,providing some ideas and reference values for SAH patients to prevent and treat the cas⁃cade reaction of CSF inflammation.

关 键 词：急性蛛网膜下腔出血 脑脊液 炎性因子 预后 

分 类 号：R743.35[医药卫生—神经病学与精神病学]