格林—巴利综合征患者血清和脑脊液中白细胞介素6检测及其意义

采用生物学方法检测了３０例ＧＢＳ患者血清及脑脊液中ＩＬ－６水平，结果表明ＧＢＳ患者血清及脑脊液中ＩＬ－６检出率及水平明显高于非炎症性神经病组及正常对照组（均Ｐ＜０．０１）；１４例血清和脑脊液均可检出ＩＬ－６的ＧＢＳ患者中，血清ＩＬ－６水平与脑脊液中ＩＬ－６水平之间无相关性（Ｐ＞０．０５）；血清ＩＬ－６检测阳性的ＧＢＳ患者中，血清免疫球蛋白水平（ＩｇＧ、ＩｇＭ、ＩｇＡ）明显高于血清ＩＬ－６检测阴性的ＧＢＳ患者及正常对照组（均Ｐ＜０．０１），而血清ＩＬ－６检测阴性的ＧＢＳ患者血清免疫球蛋白水平与正常对照组比较无明显差别（Ｐ＞０．０５）。提示ＩＬ－６与ＧＢＳ发病有关。     

缺血性脑血管病患者血清IL-8水平的变化及其临床意义

目的 观察缺血性脑血管病（ＩＣＶＤ）患者血清白细胞介素－８（ＩＬ－８）水平的变化。方法 采用双抗体夹心间接ＥＬＩＳＡ法,测定４５例ＩＣＶＤ患者（观察组）及２０名正常人（对照组）血清中ＩＬ－８水平。结果 观察组血清ＩＬ－８水平显著高于正常对照组（Ｐ〈０．０５）。观察组中发病１周内血清ＩＬ－８水平较发病１周后血清ＩＬ－８水平高（Ｐ〈０．０５）;大面积脑梗死者较小面积脑梗死者高（Ｐ〈０．０５）。结论 ＩＬ－８的变化与脑缺血的病程及缺血面积大小有关,与前者呈负相关,与后者呈正相关。脑缺血损伤引起ＩＬ－８的表达,而ＩＬ－８水平的升高又加重脑损伤的程序。     

蛛网膜下腔出血和脑梗死患者IL—6水平研究

目的 分析蛛网膜下腔出血（ＳＡＨ）和脑梗死患者血清,脑脊液（ＣＳＦ）的白细胞介素－６（ＩＬ－６）水平变化特点,探讨ＩＬ－６与ＳＡＨ和脑梗死的关系。方法 用双抗体夹心ＥＬＩＳＡ法测定２０例ＳＡＨ患者,３８例脑梗死患者及２０例正常人血清,ＣＳＦ的ＩＬ－６水平,结果 脑梗死组血清ＩＬ－６水平较对照组明显增高（Ｐ〈０．０１）,ＳＡＨ组血清,ＣＳＦ的ＩＬ－６水平较对照组明显增高（Ｐ〈０．０１）,ＳＡＨ组ＣＳ     

多发性硬化患者血清和脑脊液中白细胞介素—6的…

本研究应用生物学方法检测了２７例多发性硬化（ＭＳ）患者血清和脑脊液（ＣＳＦ）白细胞介素－６（ＩＬ－６）水平，以探讨ＩＬ－６在ＭＳ发病中的作用，结果显示ＭＳ患者血清ＩＬ－６水平显著高于共他非炎症性神经病（ＮＩＮＤ）组及正常对照（ＮＣ）组，其ＣＳＦＩＬ－６水平亦显著高于ＮＩＮＤ组，但ＭＳ患者血清与ＣＳＦＩＬ－６水平不呈线性相关，血清ＩＬ－６水平随病情稳定而下降，本研究结果提示ＩＬ－６可能参与ＭＳ的免疫     

蛛网膜下腔出血和脑梗死患者IL-6水平研究

目的分析蛛网膜下腔出血（ＳＡＨ）和脑梗死患者血清、脑脊液（ＣＳＦ）的白细胞介素-６（ＩＬ－６）水平变化特点．探讨ＩＬ－６与ＳＡＨ和脑梗死的关系。方法用双抗体夹心ＥＬＩＳＡ法测定２０例ＳＡＨ患者、３８例脑梗死患者及２０例正常人血清、ＣＳＦ的ＩＬ－６水平。结果脑梗死组血清ＩＬ－６水平较对照组明显增高（Ｐ＜０．０１）：ＳＡＨ组血清、ＣＳＦ的ＩＬ－６水平较对照组明显增高（Ｐ＜０．０１）。ＳＡＨ组ＣＳＦ的ＩＬ－６水平比血清的ＩＬ－６水平明显增高（Ｐ＜０．０１）。ＳＡＨ组第１天血清和第６天ＣＳＦ的ＩＬ－６平均水平为最高值。结论ＩＬ－６与脑梗死、ＳＡＨ发病有关，ＳＡＨ患者中枢神经系统与颅外免疫系统一样存在严重的免疫和炎症反应．而中枢神经系统与颅外免疫系统的免疫调节可能是不相同的。ＩＬ－６异常增高可能与ＳＡＨ后的脑血管痉挛（ＣＶＳ）和迟发性脑梗死有关。     

抗精神病药对血清细胞因子的影响

目的：探讨抗精神病药对精神分裂症患者血清细胞因子的影响。方法：对４６例精神分裂症患者给予抗精神病药治疗６周,在治疗前后检测血清ＩＬ－６和ＴＮＦ－α水平,并采用阳性与阴性症状量表（ＰＡＮＳＳ）、副反应量表（ＴＥＳＳ）评估临床症状变化及药物副反应。结果：抗精神病药治疗后,血清ＩＬ－６水平显著下降,血清ＴＮＦ－α水平变化不显著。治疗前血清ＩＬ－６水平与ＰＡＮＳＳ阳性因子分显血清ＩＬ－６水平显著下降,血清     

青年人脑梗塞患者血清sIL-2R和sIL-6R的研究

探讨可溶性白细胞介素２受体（ＳＩＬ－２Ｒ）和可溶性白细胞介素６受体（ｓＩＬ－６Ｒ）在青年人脑梗塞发生、发展中的作用。方法采用双抗体夹心ＥＬＩＳＡ方法对２９例青年人急性脑梗塞患者血清ｓＩＬ－２Ｒ和ｓＩＬ－６Ｒ水平进行了测定。结果青年人脑梗塞的ｓＩＬ－２Ｒ和ｓＩＬ－６Ｒ水平明显高于中、老年脑梗塞组和正常对照组,随着病情的好转,该２种受体水平也逐渐下降。结论血清ＳＩＬ－２Ｒ和ｓＩＬ－６Ｒ水平的高低可作为判断青年人急性期脑梗塞病情变化的指标之一。     

急性脑卒中患者血清一氧化氮和 炎性细胞因子测定及其临床意义

探讨急性脑卒中急性期一氧化氮（ＮＯ）和炎性细胞因子的变化与ＧＣＳ及预后的关系。方法采用硝酸还原酶法和生物素链亲和素ＥＬＩＳＡ法测定了９０例急性脑卒中患者７２ｈ内血清ＮＯ、肿瘤坏死因子（ＴＮＦα）、白细胞介素６（ＩＬ－６）、白细胞介素８（ＩＬ－８）含量,对出血性卒中同时记录ＧＣＳ及血白细胞（ＷＢＣ）计数。结果不论卒中类型,全部患者血清ＮＯ均低于对照组（Ｐ＜０．０５）,并且随脑出血容积增大递减。脑梗塞及脑出血≤２０ｍｌ组ＴＮＦα有增高趋势（Ｐ＞０．０５）,其它各组均显著增高（Ｐ＜０．０１）。全部患者ＩＬ－６及ＩＬ－８均显著增高（Ｐ＜０．０１）。出血性卒中ＧＣＳ＞８分及ＧＣＳ≤８分组ＩＬ－６、ＩＬ－８及血ＷＢＣ均有显著差异,前者死亡率为３％（１／３５）,后者死亡率为６４％（１６／２５）。结论细胞因子参与了脑卒中急性期病理生理过程,细胞因子和白细胞早期增高预示病情的严重程度及预后不良。     

格林—巴利综合征患者血清白细胞介素6动态观察及意义

目的动态观察格林－巴利综合征（ＧＢＳ）患者的血清中白细胞介素６（ＩＬ－６）水平及其临床意义。方法采用生物学方法检测３０例格林－巴利综合征（ＧＢＳ）患者血清中ＩＬ－６水平。结果ＧＢＳ患者血清ＩＬ－６水平明显高于对照组（Ｐ＜０．０５）；１０例患者动态血清ＩＬ－６及免疫球蛋白水平，发现随着监测时间的延长，血清ＩＬ－６及免疫球蛋白水平逐渐下降。但病情轻重分级之间ＩＬ－６水平无明显差别（均Ｐ＞０．０５）。结论ＩＬ－６与ＧＢＳ发病机制有关，血清ＩＬ－６监测可作为判断疾病转归的一个参考指标     

癫痫患者血清白细胞介素—6水平测定

目的探讨癫痫与白细胞介素－６（ＩＬ－６）的关系。方法采用双抗体夹心ＥＬＩＳＡ法对３３例正常对照和３６例癫痫患者血清ＩＬ－６水平进行检测。结果癫痫组血清ＩＬ－６水平显著高于对照组，血清ＩＬ－６水平变化与癫痫患者的性别、年龄、病程及发作类型无关，但与发作频率及距末次发作时间密切相关，抗癫痫药物对血清ＩＬ－６水平无明显影响。结论ＩＬ－６与癫痫发病密切相关     

IL-10 levels in cerebrospinal fluid and serum of patients with severe traumatic brain injury: relationship to IL-6, TNF-alpha, TGF-beta1 and blood-brain barrier function

Controlling the extent of inflammatory responses following brain injury may be beneficial since posttraumatic intracranial inflammation has been associated with adverse outcome. In order to elucidate the potential role of anti-inflammatory mediators, the production of interleukin-10 (IL-10) was monitored in paired cerebrospinal fluid (CSF) and serum of 28 patients with severe traumatic brain injury (TBI) and compared to control samples. The pattern of IL-10 was analyzed with respect to the patterns of IL-6, tumor necrosis factor-alpha (TNF-alpha) and transforming growth factor-beta1 (TGF-beta1) in both fluids during a time period of up to 22 days. In parallel, the function/dysfunction of the blood-brain barrier (BBB) was monitored using the CSF-/serum-albumin quotient (Q(A)) and compared to intrathecal cytokine levels. Mean IL-10 concentration in CSF was elevated in 26 out of 28 TBI patients (range: 1.3-41.7 pg/ml) compared to controls (cut-off: 1.06 pg/ml), whereas only seven patients had elevated mean IL-10 concentration in serum (range: 5.4-23 pg/ml; cut-off: 5.14 pg/ml). The time course of IL-10 was similar in both fluids, showing a peak during the first days and a second, lower rise in the second week. Intrathecal IL-10 synthesis is hypothesized since CSF-IL-10 levels exceeded serum-IL-10 levels in most of the patients, IL-10-index (CSF/serum-IL-10/QA) was elevated in 23 individuals, and elevation of CSF-IL-10 showed to be independent from severe BBB dysfunction. Neither CSF nor serum IL-10 values correlated with the dysfunction of the BBB. IL-10, IL-6 and TGF-beta1 showed similar patterns in CSF over time, whereas rises of TNF-alpha corresponded to declines of IL-10 levels. Our results suggest that IL-10 is predominantly induced intrathecally after severe TBI where it may downregulate inflammatory events following traumatic brain damage.     

急性颅脑损伤患者血清及脑脊液中炎性因子的变化及临床意义

目的探讨炎症细胞因子IL-1β,IL-6与颅脑损伤程度的关系及临床意义。方法对近年来我院收治的780例急性颅脑损伤患者按损伤程度分组（轻、中、重及特重型组）,检测血清及脑脊液中IL-1β及IL-6水平,并对比了不同程度急性颅脑损伤患者上述因子水平的差异并分析其临床意义。结果轻型、中型、重型及特重型颅脑损伤患者血清及脑脊液IL-1β及IL-6水平均显著增加,而重型和特重型颅脑损伤患者两种因子水平要显著高于其他患者,死亡患者IL-1β及IL-6水平高于其他所有患者。结论血清及脑脊液中IL-1β及IL-6水平与颅脑损伤的程度密切相关,能够作为临床监测指标。     

重型颅脑损伤患者精神障碍的临床分析

目的 探讨重型颅脑损伤后精神障碍的发生率、表现形式及影响因素。方法 以深圳市1999年10月1日至2000年9月30日因交通事故所致重型颅脑损伤的183例幸存者为研究对象,在颅脑损伤治疗后（平均6个月）,由2名精神科副主任医师根据中国精神疾病分类方案与诊断标准第2版修订本对这些伤者的精神状态进行评估。结果 （1）在183例中,罹患各类精神障碍者共165例,发生率为90．2％,其中智能障碍者为142例（77．6％）。（2）在183例,中度及其以上智力损伤者为29例（15．8％）。（3）有智力损伤组的脑干损伤、颅内血肿及≥3个脑叶损伤的比例高于无智力损伤组（P＜0．01）;伴有精神障碍组的平均年龄（P＜0．05）、脑干损伤（P＜0．05）及≥3个脑中损伤（P＜0．01）的比例高于无精神病性障碍组;有人格改变组额叶损伤、开颅清除血肿并减压治疗的比例高于无人格改变组（P＜0．01）。结论 重型颅脑损伤后精神障碍的发生率较高,应引起有关临床学科的重视。     

Interleukin-6 released in human cerebrospinal fluid following traumatic brain injury may trigger nerve growth factor production in astrocytes

Cytokines are involved in nerve regeneration by modulating the synthesis of neurotrophic factors. The role played by interleukin-6 (IL-6) in promoting nerve growth factor (NGF) after brain injury was investigated by monitoring the release of IL-6 and NGF in ventricular cerebrospinal fluid (CSF) of 22 patients with severe traumatic brain injuries. IL-6 was found in the CSF of all individuals and remained elevated for the whole study period. NGF appeared in the CSF if IL-6 levels reached high concentrations and was often detected simultaneously with or following an IL-6 peak. The amounts of NGF correlated with the severity of the injury, as indicated by the clinical outcome of the patients. The functional relationship of IL-6 and NGF was investigated utilizing cultured mouse astrocytes. The CSF of 8 patients containing IL-6 induced NGF production in astrocytes, whereas control CSF without IL-6 had no effect. The induction of NGF was inhibited up to 100% by adding anti-IL-6 antibodies. These results were corroborated when astrocytes were exposed to recombinant IL-6 at different concentrations resulting in NGF production. Thus, the production of IL-6 within the injured brain may likely contribute to the release of neurotrophic factors by astrocytes.     

Interleukin 1beta and interleukin 6 relationship with paediatric head trauma severity and outcome.

BACKGROUND: Based on the known inflammatory role of interleukins (IL), we evaluated IL-1beta and IL-6 expressions and their association with the severity of traumatic brain injury (TBI; Glasgow Coma Scale [GCS]) and the outcome (Glasgow Outcome Score [GOS]) recorded in a paediatric population. DESIGN: The design was a perspective observational clinical study carried out in the paediatric intensive care unit of the University Hospital. METHODS: We measured the IL-1beta and IL-6 levels in 14 children with severe TBI (patients) and in 12 children with obstructive hydrocephalus (control group). Cerebrospinal fluid (CSF) and plasma samples were collected 2 h (T1) and 24 h (T2) after TBI. Interleukins were assayed using the immunoenzymatic method. RESULTS: The IL-1beta mean level was significantly lower than the IL-6 mean level both in the CSF and plasma of TBI children. In the CSF, the IL-1beta level increased from 55.71+/-72.79 pg/ml at T1 to 106.10+/-142.12 pg/ml at T2 and the IL-6 level increased from 405.43+/-280.28 pg/ml at T1 to 631.57+/-385.35 pg/ml at T2; a similar trend was observed in plasma. We found a statistically significant correlation between the increase in CSF and plasma interleukin levels between T1 and T2 and head injury severity (GCS相似文献   

不同GCS评分颅脑损伤患者血清及CSF中tau及Aβ42水平及其临床意义

目的 观察颅脑损伤患者血清及CSF中tau及Aβ42水平的变化及其意义。方法 对本院2014年7月～2016年4月收入的60例颅脑损伤患者进行血清及CSF中tau蛋白及Aβ42的表达水平检测,分析其与患者损伤程度及预后的关系。结果 和对照组相比,试验A组和B组颅脑损伤患者血清及CSF中tau蛋白水平和Aβ42水平显著升高。不同时间GCS A组患者血清及CSF中tau蛋白水平和Aβ42水平显著高于GCS B组(P<0.05)。与GCS A组相比,GCS B组GOS评分为1～3分的患者比例显著降低,GOS评分为4～5分的患者比例显著增加(P<0.05)。结论 tau蛋白水平、Aβ42表达水平与颅脑损伤密切相关,可作为颅脑损伤患者预后的重要评价指标,而且Aβ42在重型创伤性颅脑损伤患者伤后认知功能障碍的病理生理机制中可能发挥着重要作用。     

颅脑损伤患者早期血清IL-6和NSE的变化及临床意义

目的探讨颅脑损伤患者早期血清IL-6和NSE的变化及与颅脑损伤程度的关系。方法用双抗体夹心酶标免疫分析法测定60例颅脑损伤患者血清IL-6和NSE的水平。结果60例颅脑损伤患者血清IL-6和NSE水平均有升高,其水平与颅脑损伤的严重程度显著相关(P<0.001),并且颅脑损伤患者血清IL-6和NSE含量之间呈正相关(r=0.417,P<0.005)。结论血清IL-6是评价颅脑损伤早期炎症损伤程度的一项重要的生化指标。     

肠内营养支持治疗对重型颅脑创伤手术后患者预后的影响

目的评价肠内营养支持治疗对重型颅脑创伤手术后患者营养状况的改善作用。方法对30例符合纳入条件的重型颅脑创伤手术后患者,经鼻胃管实施24h均匀、持续泵注肠内营养制剂(瑞素),早期以低剂量(300～400ml)过渡适应,然后根据个体差异逐渐增加剂量至足量(1500～2000ml),共治疗20d～73d(平均32d)。定期检测患者体质量以及血清白蛋白、血清前白蛋白、血红蛋白水平,并观察肠内营养支持治疗的安全性。结果治疗后肠内营养组患者体质量变化与静脉营养组相比,差异无统计学意义(P>0.05);但血清白蛋白、血清前白蛋白和血红蛋白水平降低程度明显小于静脉营养组,组间差异有统计学意义(P<0.05)。在给予肠内营养支持治疗期间,患者未发生严重的消化道并发症;肝肾功能及糖脂代谢均无明显异常。结论肠内营养具有良好的辅助治疗效果且较少发生并发症,合理的肠内营养支持治疗可有效地提高重型颅脑创伤手术后患者的康复能力。     

重型颅脑创伤后救治时间对患者预后的影响

目的 探讨重型颅脑创伤后救治时间对患者预后的影响。方法 回顾分析1998年1月～2002年2月176例交通事故所致重型颅脑创伤患者的临床资料。结果 GCS 6～8分颅脑创伤患者伤后1h内接受救治者,病死率为19.0％;随着救治时间的延长病死率呈上升趋势,分别为1～2h者病死率为26.1％,>2～5h者36.1％,>5h者42.1％,各组间差异有显著性意义(P<0.01)。GCS 3～5分颅脑创伤患者,伤后不同救治时间组之间病死率差异无显著性意义(P>0.05)。结论 重型颅脑创伤患者的预后主要取决于原发伤程度,原发伤愈重GCS评分愈低,其预后愈差;伤后救治时间愈早,患者预后相应愈好。     

早期应用纳络酮治疗急性重型颅脑外伤对照观察

目的　探讨早期应用纳络酮对急性重型颅脑外伤的影响。方法　对 95例重型颅脑损伤病人随机分成纳络酮 (NLX)治疗组 (n =48)和对照组 (n =47) ,观察治疗早期病人生命体征、颅内压、头颅CT征变化和远期疗效 ,进行统计学分析。结果　纳络酮治疗组病人呼吸循环较快恢复稳定 ,呼吸异常 ( 2 9 2 % )和心律异常 ( 3 1 3 % )明显减少 (P <0 0 1)。伤后 1周内NLX组病人颅内压显著升高和重度脑水肿者较对照组明显减少 (P <0 0 1)。NLX组治疗 1周后意识转清醒率( 5 4 2 % )高于对照组的 40 4% (P <0 0 5 ) ,伤后 3个月恢复良好率显著高于对照组 ,重残率明显减少 (P <0 0 5 )。结论　早期大剂量运用纳络酮可以降低重型颅脑外伤病人颅内压的升高幅度 ,缩短昏迷时间 ,降低伤残率 ,促进病人神经功能恢复。