【摘要】 目的探讨急性脑出血并发全身炎症反应综合征(SIRS)患者血清肿瘤坏死因子-α(TNF-α)和白细胞介素6(IL-6)含量的动态变化及其意义。方法127例急性脑出血患者分为SIRS组60例、非SIRS组67例,分别于发病内24 h及3、7、14 d晨起空腹抽取静脉血,采用双抗体夹心(ELISA)法测定血清TNF-α、IL-6水平,并观察两组患者的多器官功能障碍综合征(MODS)发生率及死亡率。结果在不同时间点,SIRS组患者的TNF-α含量差异有统计学意义(P<0.01),SIRS组的各时间点TNF-α含量均显著高于非SIRS组(P<0.01);在不同时间点,两组患者的IL-6含量差异有统计学意义(P<0.01),SIRS组的各时间点IL-6含量均显著高于非SIRS组(P<0.01);SIRS组患者的死亡率高达55%(33/60),而非SIRS患者死亡率仅7.46%(5/67),两者比较差异有统计学意义(χ2=11.39,P<0.01);SIRS组患者中有36%(22/60)出现MODS,非SIRS组中有4.48%(3/67)出现MODS,两者比较差异有统计学意义(χ2=9.87,P<0.01)。结论TNF-α及IL-6参与了脑出血后的发生、发展病理生理过程,并具有很高的预警价值。更多还原

【Abstract】 Objective To investigate the clinical significance of changes of serum TNF-α and IL-6 levels in acute cerebral hemorrhage patients with systemic inflammatory response syndrome. Methods A total of 127 patients with acute cerebral hemorrhage were divided into SIRS group(n=60) and non-SIRS group(n=67).All of the patients were all phlebotomized 3 ml of fasting venous blood in the morning within 24 hours after the incidence of the disease,and at 3,7 and 14 days.The levels of serum TNF-α and IL-6 were determined by ELISA and the incidence and mortality rates of MODS of the two groups were observed. Results Differences of serum TNF-α level in the patients of SIRS group were statistically significant at different time points(P<0.01),TNF-α achieved its peak value at 7 days in SIRS group,and it was significantly higher in SIRS group than in non-SIRS group at any time points.Differences of serum IL-6 level in all patients with cerebral hemorrhage were statistically significant at different time points(P<0.01),IL-6 achieved its peak value at 3 days in both SIRS and non-SIRS groups,and as time went by,its value was decreasing,but IL-6 was still significantly higher in SIRS group than in non-SIRS group at any time points(P<0.01).The mortality rate of SIRS group reached 55%(33/60),while the mortality rate of non-SIRS group was only 7.46%(5/67).Multiple organ dysfunction syndrome(MODS) occurred in 36%(22/60) patients of SIRS group and in 4.48%(3/67) patients of non-SIRS group.There were significantly differences in mortality rate and MODS between the two groups(χ2=11.39,χ2=9.87,P<0.01). Conclusions TNF-α and IL-6 participate in the occurrence and development of SIRS after cerebral hemorrhage,and have a high foretell value to cerebral hemorrhage accompanied with or without MODS.更多还原