颅脑损伤后脑脊液TNF-α、IL-6的动态变化

目的探讨颅脑损伤后51例患者伤后不同时期脑脊液中IL-6、TNF—α的变化。方法检测51例急性颅脑损伤患者脑脊液IL-6、TNF—α含量的变化，统计学方法处理分析急性颅脑损伤分级脑脊液中IL-6、TNF—α含量之间的关系以及其变化趋势。结果：与正常对照组相比，颅脑损伤患者伤后第1、3、7、14天脑脊液IL-6均有明显增高（P〈0．01）。重型组明显高于轻、中型组；在轻型组IL-6早期升高，后期下降迅速；中型组于14天接近正常，重型组下降较慢，于14天时仍处于较高水平。本研究发现TNF—α在颅脑损伤后的早期在脑脊液中升高，随即迅速回落至基础值；没有产生与脑水肿高峰期相吻合的第二个峰值或持续升高。结论对于临床诊断和严重程度判断以及指导不同颅脑损伤在某时段遏制炎症，提高颅脑损伤救治水平监测颅脑损伤后患者脑脊液中IL-6具有十分重要的意义．而监测TNF—α水平价值不如IL-6。

Changes in levels of cerebrospinal fluid TNF-α、IL-6 in patients with acute brain trauma

Objective studying the changes in the levels of cerebrospinal fluid tumor necrosis factor alpha（TNF-α） and interleukin-6 （IL-6） and their clinical significance in 51 patints with acute brain trauma in the different periods. Methods The relationship between the severity of brain injury and the levels of cerebrospinal fluid TNF-α, IL-6 was analyzed in 51 patients with acute brain trauma. The data was headled dy statistics. Results Compared with the control group, the levels of cerebrospinal fluid IL-6 on the lst,3rd,7th,andl4th day after brain trauma was significantly elevated; The levels of IL-6 in the patients with severe traumatic brain injuw were significantly higher than that in the patients with mild and moderate injury （P〈0.01）. In the mild group, the level of IL-6 was elevated in the early phase and decreased in the later phase; in the moderate group, closed to normal in 14th day after trauma, in the severe group still remained bigb level. This study discovered the levels of cerebrospinal fluid TNF-α after trauma were significantly higher, maybe express in the earlier period after brain trauma and recover to normal quickly; didn＇t create the second peak corresponding to the peak of brain edema or heighten persistently. Conclusion With regard to make clinical diagnosis, judge severity of brain trauma, contain inflammatory reaction with various degrees of brain trauma in certain period, and improve the treatment of brain trauma; monitoring the levels of cerebrospinal fluid IL-6 after brain trauma has great significance, and monitoring the levels of cerebrospinal fluid TNF-α after brain trauma has less value than the levels of IL-6