【摘要】 目的探讨创伤性蛛网膜下腔出血(TSAH)患者脑脊液中肿瘤坏死因子α(TNF-α)、白介素1β(IL-1β)表达水平及其临床意义。方法选取2010年1月至2012年12月35例TSAH患者为研究对象,根据格拉斯哥昏迷(GCS)评分法将患者分为轻度组(GCS 13～15分)12例,中度组(GCS 9～12分)12例,重度组(GCS 3～8分)11例。选取12例腰麻下肢骨折内固定取出手术者作为对照组。TSAH患者于伤后第1、2、3、5、7、10、14天分别腰穿或腰大池抽取脑脊液,采用酶联免疫吸附试验法测定TNF-α、IL-1β在脑脊液中相对含量。结果三组TSAH患者脑脊液中TNF-α、IL-1β在伤后均有明显升高,且明显高于照组;重度组高于中、轻度组,差异均有统计学意义(P<0.05或0.01)。重度组伤后第1天和第5天出现2次峰值,轻、中度组伤后第2天达到高峰,三组TSAH患者伤后第14天仍高于正常水平。结论 TSAH后TNF-α、IL-1β在脑脊液中含量明显增高,持续较长时间,可作为TSAH指导治疗、判断预后的检测指标。更多还原

【Abstract】 Objective To investigate expression level and clinical significance of tumor necrosis factor(TNF-α),interleukin(IL-1β) in cerebrospinal fluid(CSF) of patients with traumatic subarachnoid hemorrhage(TSAH). Methods 35 TSAH patients from January 2010 to December 2012 were selected as study object. According to Glasgow Coma Scale(GCS),patients were divided into mild(with the GCS score from 13 to 15,n=12) group,moderate(with the GCS score from 9 to 12,n=12) group and severe(with the GCS score from 3 to 8,n=11) group. 12 patients with lumbar anesthesia were taken as the control group. The relative content TNF-α,IL-1β in the cerebrospinal fluid was checked on 1st,2nd,3rd,5th,7th,10th and 14th day after injury through lumbar puncture or lumbar cerebrospinal fluid specimens by enzyme linked immunosorbent assay(ELISA). Results TNF-α and IL-1β in CSF of patients with TSAH in three groups were increased significantly after injury,and the TNF-α and IL-1βin mild group,moderate group and severe group were obviously higher than those in control group;meanwhile TNF-α and IL-1β in severe group were higher than those in moderate group and mild group with statistically significant difference(P<0.05 or 0.01).The severe group reached peak on 1st day and 5th day after injury,the mild group and moderate group reached peak on 2nd day after injury,but levels of TNF-α and IL-1β of patients with TSAH in three groups were still higher than normal level on 14th day after injury. Conclusion The contents of TNF-α and IL-1β in CSF after TSAH increase obviously and last a longtime,which can be taken as detection index for guide treatment and judgement prognosis of TSAH.更多还原