颅脑损伤后血清IL-1βIL6的变化及临床意义Changes and clinical significance of serum IL1-beta,IL6 in patients with brain injury
钟宝;万野;邹敏;熊小军;
摘要(Abstract):
目的通过测定炎症因子IL-1β、IL-6在颅脑损伤患者血清中的含量变化,探讨IL-1、IL-6与颅脑损伤程度以及预后的关系。方法选取2012-01—2015-12荆门市第二人民医院收治的256例颅脑损伤患者为研究对象,根据其颅脑损伤严重程度分为轻度组98例,中度组93例及重度组65例,选取同期本院门诊体检正常者50例为对照组,分别在受伤后第1天、第3天、第5天、第7天、第10天、第14天采用酶联免疫吸附法(ELISA)检测所有患者血清中的IL-1β、IL-6含量,对比不同组别之间IL-1β、IL-6的差异并分析其变化的临床意义;根据死亡、植物人、重残、中残、良好5种不同预后情况进行重新归纳分组,分析每组患者IL-1β、IL-6含量的差异并进行分析。结果颅脑损伤组患者血清中IL-1β、IL-6的含量均高于对照组(P<0.05),且重度颅脑损伤组血清IL-1β、IL-6含量明显高于轻度组和中度组(P<0.05),预后死亡组、植物生存状态组以及重残生存组的IL-1β、IL-6含量明显高于中残组和预后良好组(P<0.05),死亡组和植物生存组IL-1β、IL-6含量高于重残组,差异具有统计学意义(P<0.05)。结论炎症细胞因子IL-1β、IL-6在颅脑损伤患者血清中的含量与损伤严重程度以及预后有密切联系,检测其含量可以作为评估颅脑损伤程度的重要指标。
关键词(KeyWords): 颅脑损伤;白细胞介素-1β;白介素-6;血清;预后;炎症反应
基金项目(Foundation): 湖北省自然科学基金项目,编号:2016cfb110
作者(Authors): 钟宝;万野;邹敏;熊小军;
参考文献(References):
- [1]费舟,屈延.颅脑创伤的循证医学思考[J].中华神经医学杂志,2014,13(5):433-437.
- [2]KEEL M,TRENTZ O.Pathophysiology of polytrauma[J].Injury,2005,36(6):691-709.
- [3]张中原.颅脑损伤后血清、脑脊液IL1β,IL6的变化及临床意义[D].天津:天津医科大学,2012.
- [4]王忠诚.王忠诚神经外科学[M].武汉:湖北科学技术出版社,2005:284.
- [5]JOHNSON V E,MEANEY D F,D KACY C,et al.Animal models of traumatic brain injury[J].Handbook of Clinical Neurology,2015,127(1):115-139.
- [6]MENG X,ZHANG Y,LI N,et al.Effect of hyperbaric oxygen therapy on Akt signaling pathway in secondary injury associated with brain trauma[J].Int J Clin Exp Med,2016,9(3):6 539-6 544.
- [7]张为丹,赵敬,翟瑄.脑创伤后炎症反应与免疫抑制[J].重庆医科大学学报,2016,41(1):1-4.
- [8]HOLMIN S,MATHIESEN T.Intracerebra administration of interleukin-1beta and induction of inflammation.Apoptosis and vasogenicedema[J].J Neurosurg,2000,92(1):108-120.
- [9]唐芳芳.TLR4、NF?κB及IL-1β在创伤性脑损伤大鼠脑组织中的表达[D].郑州:郑州大学,2015.
- [10]WOODROOFE M N.Cytokine production in the central n-ervous system[J].Neurology,1995,45(6):6-10.
- [11]REINSFELT B,RICKSTEN S E,ZETTERBERG H,et al.Cerebrospinalfluid markers of brain injury,inflammation,and blood-brain barrier dysfunction in cardiac surgery[J].Ann Thorac Surg,2012,94(2):549-555.
- [12]LEE S H,KIM B J,KIM Y B,et al.IL-1βinduction and IL-6suppression are associated with aggravated neuro-nal damage ina lipopolysaccharide-pretreated kainic acid-induced rat pupseizure model[J].Neuroimmunomodulation,2012,19(5):319-325.
- [13]KOSSMANN T,HANS V H,IMHOF H G.Intrathecal and serum interleukin-6 and the acute-phase response in patients with severe traumatic brain injury[J].Shock,2000,17(3):308-315.
- [14]HAYAKATA T,SHIOZAKI T,TASAKI O,et al.Change in CSFS100Band cytokine concentration in early-phase severe traumatic brain injury[J].Shock,2004,22(2):102-107.
- [15]安模,苗露,黄春云,等.急性颅脑损伤患者血清及脑脊液中炎性因子的变化及临床意义[J].国际神经病学神经外科学杂志,2013,40(5/6):408-411.