摘要
目的动态观察急性幕上自发性脑出血患者血清白细胞介素6（IL-6）的变化规律，探讨其与脑出血体积、部位、神经功能缺损程度以及患者年龄、性别等方面的相关性。方法该实验采用酶联免疫吸附测定（ELISA）法对40倒急性幕上自发性脑出血患者发病后血清IL-6水平进行动态检测，并与30例健康对照组进行比较，同时应用头颅CT测定出血体积、判断出血部位；应用斯堪的那维亚卒中量表（scandinavia stroke scale，SSS）于发病1周内对患者进行神经功能缺损程度评分。结果急性幕上自发性脑出血患者在发病早期48小时内血清IL-6浓度即明显升高，3～5天达到峰值，明显高于健康对照组[48小时（18．55±5．10）ng／L、3～5天（23．70±4．91）ng／LVS（8．71±3．89）ng／L，均P〈0．01]；随后逐渐下降，至发病后6～9天接近对照组水平[（10．83±4．53）ng／LVS（8．71±3．89）ng／L，P〉0，053；脑出血患者急性期（发病1周内）IL-6平均血清含量与出血量大小呈显著正相关（rs=0．931，P〈0．01）；与神经功能缺损程度也呈显著正相关（rs=0．374，P〈0．01）；有严重神经功能缺失的患者IL-6升高更明显，IL-6〉25ng／L、SSS评分〉40分均提示患者预后不良。结论IL-6是炎症反应的标记物，在脑出血中起重要作用；其与出血量大小和神经功能缺损程度呈正相关，可以作为急性脑出血的早期诊断、判断病情转归和预后的综合指标，同时为脑出血的抗炎治疗提供了理论基础。
Objective To evaluate the significance of interleukin-6 （IL-6） concentration in the serum from patients with acute spontaneous supratentorial intracerebral hemorrhage and to explore the correlation between the parameter and neurologic deficits, volume and site of hemorrhage,age and sex. Methods The level of IL-6 in the serum was serially determined in 40 patients with intracerebral hemorrhage（ICH） and in 30 control subjects using enzyme-linked immunosorbent assay（ELISA）. The neurological status was evaluated by scandinavia stroke scale（SSS） at 7th day after onset of ICH, and the craniocerebral computed tomography（CCT） was also serially performed to calculate the volume of hemorrage and to locate the site of hemorrhage. Results The serum concentration of IL-6 increased within 48 hours after ICH in ICH group peaked at 3 rd-5th day, compared with the control group, there were significant differences[48 h（18.55±5.10） ng/L,3-5 days（23.70±4.91） ng/L vs （8.71±3.89） ng/L, P 〈0. 013. Then IL-6 began to decrease gradually. The serum concentration of IL-6 fell to the approximate normal level at 6-9th day, compared with the control group,no significant changes were found between two groups[（10.83-±4.53） ng/L vs （8.71±3.89） ng/L,P 〉0. 053. There was a positive corrlation beween the mean IL-6 concentration in serum and the volume of hemorrhage, in the first week of ICH （ rs =0. 931, P 〈0.01） ; IL-6 was also associated with the scores of neurological function as assessed by SSS（ rs = 0. 374, P 〈0.01）. IL-6 concentration in serum was significantly higher in the patients with severe neurological deficits than in the others, when IL-6〉 25 ng/L or SSS 〉 40 point indicating poor prognosis. Conclusion IL-6 is a marker of inflammatory response, which plays important role in the process of ICH. There was positive correlation between mean IL-6 serum level and the volume of hemorrhage, the scores of neurological function assessed by SSS in the first week of ICH; IL-6 level in serum may be served as a comprehensive index of early diagnosis,evaluation of seriousness and prognosis in ICH, and may provide a theoretical basis for the anti-inflammatory therapy in ICH.
出处
《临床荟萃》
CAS
北大核心
2007年第2期89-92,共4页
Clinical Focus
关键词
脑出血
白细胞介素6
预后
intracerebral hemorrhage
interleukin-6
prognosis
