摘要
目的:研究颅脑损伤后患者血清中TNF-α、IL-6及CRP的动态变化及意义。方法:100例颅脑损伤患者按照GCS计分法分为轻型组(38例)、中型组(32例)、重型组(30例),30例健康体检者为对照组。用双抗体夹心ELISA法及透射免疫比浊法测定颅脑损伤患者伤后1、3、7、14d血清中TNF-α、IL-6及CRP水平。结果:颅脑损伤后各时间点血清TNF-α、IL-6及CRP含量均高于正常对照组,差异有统计学意义(P<0.05)。TNF-α于伤后第1天开始升高,于伤后第3天达到高峰,伤后第7天开始下降,但仍高于对照组(P<0.05)。IL-6及CRP于伤后第1天达到高峰,伤后第3天开始下降,但仍高于对照组(P<0.05)。重型组TNF-α、IL-6及CRP含量均明显高于轻、中型组(P<0.01),中型组高于轻型组(P<0.05)。各个时间点的血清TNF-α、IL-6及CRP含量与颅脑损伤程度呈正相关(r=0.482,P<0.01;r=0.563,P<0.01;r=0.617,P<0.01)。结论:血清中TNF-α、IL-6及CRP含量在颅脑损伤后明显升高,与颅脑损伤程度呈正相关。TNF-α参与了颅脑损伤的炎性损伤过程,急性期其损害作用是主要的;IL-6及CRP可从一定程度上反映颅脑损伤患者的病情严重程度。因此,动态监测颅脑损伤患者血清TNF-α、IL-6及CRP水平对判断病情的严重程度及预后有重要的价值。
Objective：To explore the serum TNF-α,IL-6 and the dynamic changes of the CRP and their clinical significance in patients with traumatic brain injury.Methods：100 cases of patients with traumatic brain injury were divided into three groups（gentle 38 cases,medium 32 cases and severity group 30 cases） based on the GCS coma scale,and 30 cases of healthy people were used as controls.The concentration of serum TNF-α,IL-6 and CRP were detected with ABC-ELISA and immunoturbidimetry after traumatic brain injury on 1,3,7,14 d after injury.Results：The serum TNF-α,IL-6 and CRP levels were higher than normal control group at each time of detection,there was a significant difference（P0.05）.After the wound,TNF-α began to rise from the first day and reached to the peak in the third day,then began to drop in the seventh day,but was still higher than control group（P0.05）.IL-6 and CRP reached to the peak in the first day,and began to drop after the third day,but was still higher than those in the control group（P0.05）.In the severe traumatic brain injury group,the levels of TNF-α,IL-6 and CRP were significantly higher than those of gentle,medium group（P0.01）,the medium group was higher than gentle group（P0.05）.The serum TNF-α,IL-6 and CRP levels were positively correlated with traumatic brain injury levels（r=0.482,P0.01;r=0.563,P0.01;r=0.617,P0.01）.Conclusion：The serum TNF-α,IL-6 and CRP levels in traumatic brain injury patients are increased significantly,and is in positive correlation with the levels of the injury.In the inflammatory lesions during the acute traumatic brain injury,the TNF-α plays a remarkable role and the damage is severe.The serum IL-6 and CRP also can reflect how severe the traumatic brain injury is.Therefore,the dynamic observation of serum TNF-α,IL-6 and CRP levels is of important value for the judging the severity and the prognosis in patients with traumatic brain injury.
出处
《中国医药导报》
CAS
2010年第21期19-21,共3页
China Medical Herald
