【摘要】 目的研究血清中炎性因子IL-6、IL-10在高渗盐液救治重型颅脑损伤患者的意义。方法选择54例重型颅脑损伤患者,随机分为高渗盐液组和常规液组,每组27例。另设健康对照组(20例)清晨抽取静脉血,留送IL-6、IL-10检测。观察2组在住院第1、3、5、7天检测血清IL-6、IL-10浓度,统计28d患者并发症发生率及病死率。结果2组IL-6、IL-10水平,显著高于对照组;高渗盐液组IL-6水平,显著低于常规液组;死亡组的IL-6浓度高于存活组(P<0.01);常规液组和死亡组IL-10浓度分别与高渗盐液组和存活组比较差异无统计学意义(P>0.05)。2组并发症发生率比较在常规液组29.63%,高渗盐液组25.93%;病死率分别为常规液组40.74%,高渗盐液组37.04%,两者比较差异无统计学意义(P>0.05);结论血清中IL-6,IL-10参与了颅脑损伤的病理生理过程,其测定IL-6对早期评估重型颅脑损伤的预后有重要临床意义;高渗盐液能降低炎性因子浓度,减轻炎性反应,具有较好的应用前景。更多还原

【Abstract】 Objective To investigate the significance of IL-6 and IL-10 in patients with severe brain trauma treated by hypertonic saline.Methods 54 eligible patients with severe head injury were randomly divided into two groups and 20 healthy subjects were enrolled as control group.The 27 patients in hypertonic saline group were infused with 7.5% hypertonic saline(4ml/kg).The other 27 patients in conventional liquid group were infused with conventional liquid(crystalloid).The serum levels of IL-6 and IL-10 were detected at 1,3,5,7d after hospitalization,and the incidence rate of complication and mortality were recorded at 28d after hospitalization.Results The serum levels of IL-6 and IL-10 in both groups were significantly higher than those of healthy control group(P<0.01).The levels of IL-6 in hypertonic saline group were significantly lower than those in conventional liquid group(P<0.05).The levels of IL-6 in non-survival group were significantly higher than those in survival group(P<0.01).There were no significant differences in the levels of IL-10 between the two group(P>0.05).There were no significant differences in complications between two groups(37.78% in conventional liquid group vs 35.46% in hypertonic saline group(P>0.05).The mortality was 40.71% in conventional liquid group and 38.65% in hypertonic saline group(P>0.05).Conclusion The serum levels of IL-6 and IL-10 are involved in the pathological process of severe brain injury.The detection of IL-6 levels is of clinical importance for evaluating patients’ prognosis.Furthermore the infusion of hypertonic saline is effective for resuscitation of severe head injury,which can reduce the levels of IL-6 and can relieve inflammatory response.更多还原