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目的:探讨甲强龙对重型颅脑损伤患者血清中白细胞介素-1β(IL-1β)及肿瘤坏死因子-α(TNF-α)的表达影响。方法:收集我院神经外科以重型颅脑损伤为诊断收治入院的患者68例,并将其随机分为实验组和对照组。实验组予以甲强龙治疗,对照组则给予地塞米松治疗,同时两组均予以利尿、降颅压、抗感染、抑酸、营养支持等常规对症支持治疗。分别于治疗前、治疗后第1、3、7天进行血清IL-1β和TNF-α水平测定,并于治疗3个月后按GOS预后评分标准进行预后评估。结果:1与治疗前比较,治疗后1天IL-1β水平及TNF-α水平较高(P<0.05),第3、7天IL-1β水平及TNF-α水平较低(P<0.05)。与对照组同期比较,实验组第1天IL-1β水平及TNF-α水平较高(P<0.05),第3、7天IL-1β水平及TNF-α水平较低(P<0.05),2治疗后实验组死亡率明显低于对照组,差异有统计学意义(P<0.05)。结论:甲强龙可显著改善重型颅脑损伤患者的预后,这可能与其抑制血清IL-1β和TNF-α的表达有关。
Objective: To investigate the effects of methylprednisolone on the expression of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in patients with severe craniocerebral injury. Methods: A total of 68 patients admitted to our hospital for neurosurgery with severe craniocerebral injury were selected and randomly divided into experimental group and control group. The experimental group was treated with methylprednisolone, while the control group was treated with dexamethasone. At the same time, both groups were given conventional symptomatic and supportive treatment such as diuretic, intracranial pressure reduction, anti-infection, acid suppression and nutritional support. Serum levels of IL-1β and TNF-α were measured before treatment and on the 1st, 3rd, 7th day after treatment, and prognosis was evaluated according to the GOS prognostic score after 3 months of treatment. The levels of IL-1β and TNF-α were higher on the 1st day after treatment (P <0.05), and the levels of IL-1β and TNF-α were lower on the 3rd and 7th day (P <0.05) . Compared with the control group, the level of IL-1β and TNF-α in the experimental group were higher on the first day (P <0.05), the levels of IL-1β and TNF-α were lower on the 3rd and 7th day (P <0.05) 2 after treatment, experimental group mortality was significantly lower than the control group, the difference was statistically significant (P <0.05). Conclusion: Methylprednisolone can significantly improve the prognosis of patients with severe craniocerebral injury, which may be related to its inhibition of serum IL-1β and TNF-α expression.