ET-1、IL-6以及可溶性白介素-2受体与颅脑损伤后脑血管痉挛的相关性分析  

Correlation Analysis of ET-1,IL-6 and Soluble Interleukin-2 Receptor with Cerebral Vasospasm after Craniocerebral Injury

作　　者：皮亮 周雷廷 李子博 PI Liang;ZHOU Leiting;LI Zibo(Neurosurgery Department,Zhoukou Central Hospital,Zhoukou City,He’nan Province 466700)

机构地区：[1]河南省周口市中心医院神经外科,466700

出　　处：《医学理论与实践》2024年第5期734-737,747,共5页The Journal of Medical Theory and Practice

摘　　要：目的:探讨内皮素-1(ET-1)、白细胞介素-6(IL-6)以及可溶性白介素-2受体(SIL-2R)与颅脑损伤后脑血管痉挛的相关性。方法:选取我院2019年10月—2022年10月收治的102例颅脑损伤患者作为研究对象,均对所有患者采用经颅多普勒血流分析仪检测其平均血流速度,根据血流速度划分为单纯颅脑损伤组(36例)、轻症痉挛组(41例)、重症痉挛组(25例)。对比三组患者ET-1、IL-6、SIL-2R表达水平,并分析ET-1、IL-6、SIL-2R与颅脑损伤后脑血管痉挛的相关性。随后建立受试者特征工作(ROC)曲线,分析ET-1、IL-6、SIL-2R对颅脑损伤后脑血管痉挛的诊断效能。对66例颅脑损伤后脑血管痉挛患者进行随访,将治疗后重新进入ICU与院内死亡的21例患者分为预后不良组,将其余45例患者分为预后良好组,对比预后不良组和预后良好组患者临床一般情况,并分析ET-1、IL-6、SIL-2R对颅脑损伤后脑血管痉挛的预后预测价值。结果:重症痉挛组血清ET-1、IL-6、SIL-2R水平高于轻症痉挛组和单纯颅脑损伤组(P<0.05);Spearman相关分析结果显示,ET-1、IL-6、SIL-2R与颅脑损伤后脑血管痉挛呈正相关(P<0.05);ET-1、IL-6、SIL-2R及三者联合对颅脑损伤后脑血管痉挛的ROC曲线面积(AUC)依次为0.688、0.667、0.656、0.821;且三者联合的诊断灵敏度(74.58%)和特异度(86.32%)高于单独诊断;预后良好组与预后不良组患者性别、年龄、BMI、颅脑损伤类型对比无明显差异(P>0.05),预后良好组和预后不良组患者脑挫伤范围、就诊时间、APACHEⅡ评分、平均血流速度、ET-1、IL-6、SIL-2R水平对比差异显著(P<0.05);Logistic回归分析结果表明:APACHEⅡ评分、平均血流速度、ET-1、IL-6、SIL-2R为颅脑损伤后脑血管痉挛预后不良的独立影响因素(P<0.05)。结论:颅脑损伤后重症脑血管痉挛患者血清ET-1、IL-6、SIL-2R水平明显升高,三者联合对于脑血管痉挛的诊断价值较高,且三者为颅脑损Objective:To explore the correlation between endothelin-1(ET-1),interleukin-6(IL-6)and soluble interleukin-2 receptor(SIL-2R)and cerebral vasospasm after brain injury.Methods:A total of 102 patients with craniocerebral injury admitted to our hospital from October 2019 to October 2022 were selected as research objects.Transcranial Doppler blood flow analyzer was used to detect the average blood flow velocity of all patients,and they were divided into simple craniocerebral injury group(36 cases),mild spasm group(41 cases)and severe spasm group(25 cases)according to blood flow velocity.The expression levels of ET-1,IL-6 and SIL-2R in three groups were compared,and the correlation between ET-1,IL-6 and SIL-2R and cerebral vasospasm after craniocerebral injury was analyzed.Subsequently,receiver characteristic operating(ROC)curve was established to analyze the diagnostic efficacy of ET-1,IL-6 and SIL-2R on cerebral vasospasm after craniocerebral injury.66 patients with cerebral vasospasm after craniocerebral injury were followed up.21 patients who were re-admitted to ICU after treatment and died in hospital were divided into a poor prognosis group,and the remaining 45 patients were divided into a good prognosis group.The general clinical conditions of the poor prognosis group and good prognosis group were compared,and the prognostic value of ET-1,IL-6 and SIL-2R on cerebral vasospasm after craniocerebral injury was analyzed.Results:Serum levels of ET-1,IL-6 and SIL-2R in severe spasm group were higher than those in mild spasm group and simple craniocerebral injury group(P<0.05).Spearman correlation analysis showed that ET-1,IL-6 and SIL-2R were positively correlated with cerebral vasospasm after craniocerebral injury(P<0.05).The ROC curve area(AUC)of ET-1,IL-6,SIL-2R and their combination on cerebral vasospasm after craniocerebral injury were 0.688,0.667,0.656 and 0.821,respectively.The sensitivity(74.58%)and specificity(86.32%)of combined diagnosis were higher than those of single diagnosis.There were no significant d

关 键 词：内皮素-1 白细胞介素-6 可溶性白介素-2受体 颅脑损伤 脑血管痉挛 预后预测 

分 类 号：R651.15[医药卫生—外科学]