脊髓损伤后不同免疫条件下血清IL-6、IL-8、TNF-α含量的变化与意义

目的了解脊髓损伤后不同免疫条件下血清IL-6、和IL-8、TNF-α含量的变化并探讨其意义。方法对58例脊髓损伤患者分为激素冲击组（24例）及非冲击组（34例）,所有患者于伤后第1、3、7天分别抽取外周血,应用放射免疫分析方法进行血清IL-6、和IL-8、TNF-α含量的检测。同时以健康志愿者20例作为对照。结果58例术后3周全部得到随访,其中17例神经功能获得明显恢复（17例肌力进展≥2级,称进步组,41例肌力进展〈2级,称缓慢组）。损伤组在3次血清IL-6、IL-8、TNF-α水平检测中均明显高于对照组。但激素冲击组血清IL-8、TNF-α水平于伤后第3、7天两次检测均明显较非冲击组为低。同时进步组IL-6一直维持较高水平,但IL-8、TNF-α在第3、7天均较低。结论IL-6、和IL-8、TNF-α在脊髓损伤中均起重要作用,激素可明显抑制IL-8、TNF-α的分泌,但脊髓损伤后IL-6持续升高可能预示着脊髓损伤患者有较好的预后。

Significances of alterations of serum IL-6, IL-8 and TNF-α level following spinal cord injury on different immune status

Objective To study the significances of alterations of serum IL-6, IL-8 and TNF-α level following spinal cord injury on different immune status. Methods 58 cases of spinal cord injury patients were drew peripheral blood for detection of IL-6,IL-8 and TNF-α level by the radioimmunology analysis methods at first day, third day and sev-enth day after spinal cord injury. They were divided into MP-group（24 cases） and nonMP-group （34 cases）. 20 cases of volunteers were enrolled as control. Results All patients were followed up for 3 weeks. 17 of 58 had been obviously improved （17 cases recovered ≥2 grade in myosthemie class which was called rapid-improved group. The other 41 cases 〈 2 grade called slow-improved group）. Compared with the control group, serum IL-6, IL-8 and TNF-α level were elevated obviously at the time of 24 h after spinal cord injmy, but the serum IL-8 and TNF-α level in the MP-group were much lower than that in the nonMP-group at the time of third day and seventh day. Compared with the slow-improved group, the rapid-improved group had a high serum level of IL-6 all the time after spinal cord injmy, but had a lower serum level of IL-8 and TNF-α at the third day and seventh day. Conclusions IL-6, IL-8,TNF-α are importance cytokines in the course of spinal cord injury. MP can inhibit the secretion of IL-8 and TNF-α after spi- nal cord injury. The sustained high serum level of IL-6 after spinal cord injury may indicate that the patient would have an related good prognosis.