微创碎吸术手术时机对高血压脑出血患者血清炎性细胞因子水平的影响

目的观察微创碎吸术手术时机对高血压脑出血患者血清细胞因子水平及临床疗效的影响。方法70例高血压脑出血患者据病后手术时间分为Ⅰ组(<6 h,39例)和Ⅱ组(6～24 h,31例),同时选择10例健康人作为健康对照组,连续监测血清中肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)的动态变化。按脑卒中患者临床神经功能缺损程度评分标准进行临床疗效评定。结果除Ⅰ组术后168 h外,术后各时点2组患者的TNF-α、IL-6含量均高于健康对照组(P<0.01)。Ⅰ组患者TNF-α、IL-6含量达峰时间早;Ⅱ组患者TNF-α、IL-6含量达峰时间较晚,且TNF-α、IL-6水平较高。与Ⅱ组相比,Ⅰ组患者总有效率高,住院时间短(P<0.05)。结论及早手术可降低血清中TNF-α、IL-6水平,改善患者预后。

Treatment of hypertensive intracerebral hemorrhage with micro-injury operation and dynamic change of inflammatory cytokine in hematomal fluid of cerebral hemorrhage

Objective To investigate the therapeutic effect of micro-injury operation and dynamic changes of inflammatory eytokines in hypertensive cerebral hemorrhage. Methods Totally 70 patients with hypertensive cerebral hemorrhage underwent micro-injury operation. The cases were divided into two groups according to the operation time ： group Ⅰ （ 〈6 h, n =39） ,which underwent the operations within 6 hours after onset,and group Ⅱ（6 -24 h, n =31 ）, which underwent operation from 6 to 24 hour after onset. Another 10 serum samples of healthy persons were tested as control. The changes of TNF-α, IL-6 were dynamic monitored, and the therapeutic effect was evaluated according to scoring criteria of neurological impairment. Results The levels of TNF-α and IL-6 in patients were higher than that of healthy control group （ P 〈 0.01 ）, except of the time point 168h post surgery. The peak time of serum TNF-α and IL-6 was earlier in group Ⅰ than group Ⅱ, and higher concentrate in group Ⅰ. Furthermore, the totally efficiency rate was higher in group Ⅰ than group Ⅱ, and shorten the length of stay in hospital （ P 〈 0.05 ）. Conclusion It suggested that the micro-injury operation should do as early as possible for hypertensive cerebral hemorrhage patients, which could decrease the serum levels of TNF-α and IL-6, and improve their prognosis.