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目的探讨急性脑出血患者并发全身炎症反应(SIRS)后TNF-α、IL-10情况及其与多脏器功能障碍综合征(MODS)、死亡率的关系。方法60例急性脑出血患者分为SIRS组(28例)、non-SIRS组(32例),分别于发病24h内及3、7、14d晨起空腹抽取静脉血3mL,采用放射免疫法测定血清TNF-α、IL-10水平,并观察两组患者MODS的发生率、死亡率。结果在不同的时间点,脑出血患者TNF-α差异有显著性(P=0.000);SIRS组在3d、7d时TNF-α达到高峰;与non-SIRS组比较,各时间点均以SIRS组的TNF-α较高(P=0.000)。在不同的时间点,脑出血患者IL-10差异有显著性(P=0.000);SIRS组、non-SIRS组在3d时IL-10达到高峰,以后随时间逐渐下降;与non-SIRS组比较,各时间点均以SIRS组IL-10较高(P=0.000)。SIRS组10例出现MODS,non-SIRS组仅2例,两者差异存在显著性(P=0.004)。SIRS组15例死亡,non-SIRS组仅3例,两者差异存在显著性(P=0.000)。结论TNF-α及IL-10参与了脑出血后SIRS的发生、发展过程,TNF-α和IL-10可作为预测MODS的早期指标。
Objective To investigate the relationship between TNF-α, IL-10 and multiple organ dysfunction syndrome (MODS) and mortality in patients with acute cerebral hemorrhage complicated with systemic inflammatory response (SIRS). Methods Sixty patients with acute cerebral hemorrhage were divided into 3 groups: SIRS group (n = 28) and non-SIRS group (n = 32) TNF-α, IL-10 levels, and to observe the incidence of MODS and mortality in both groups. Results At different time points, there was a significant difference of TNF-α in patients with cerebral hemorrhage (P = 0.000). In SIRS group, TNF-α peaked at 3d and 7d. Compared with non-SIRS group, SIRS group TNF-α was higher (P = 0.000). At different time points, there was a significant difference of IL-10 in patients with cerebral hemorrhage (P = 0.000); in SIRS group, non-SIRS group reached peak at 3d and then decreased gradually with time; Compared with non-SIRS group , IL-10 was higher in SIRS group at each time point (P = 0.000). There were 10 cases of MODS in the SIRS group and 2 cases in the non-SIRS group, the difference was significant (P = 0.004). There were 15 deaths in the SIRS group and 3 in the non-SIRS group (P = 0.000). Conclusion TNF-α and IL-10 are involved in the occurrence and development of SIRS after intracerebral hemorrhage. TNF-α and IL-10 may be used as early predictors of MODS.