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目的探讨急性脑出血并发全身炎症反应综合征(SIRS)患者血清肿瘤坏死因子-α(TNF-α)和白细胞介素6(IL-6)含量的动态变化及其意义。方法127例急性脑出血患者分为SIRS组60例、非SIRS组67例,分别于发病内24 h及3、7、14 d晨起空腹抽取静脉血,采用双抗体夹心(ELISA)法测定血清TNF-α、IL-6水平,并观察两组患者的多器官功能障碍综合征(MODS)发生率及死亡率。结果在不同时间点,SIRS组患者的TNF-α含量差异有统计学意义(P<0.01),SIRS组的各时间点TNF-α含量均显著高于非SIRS组(P<0.01);在不同时间点,两组患者的IL-6含量差异有统计学意义(P<0.01),SIRS组的各时间点IL-6含量均显著高于非SIRS组(P<0.01);SIRS组患者的死亡率高达55%(33/60),而非SIRS患者死亡率仅7.46%(5/67),两者比较差异有统计学意义(χ2=11.39,P<0.01);SIRS组患者中有36%(22/60)出现MODS,非SIRS组中有4.48%(3/67)出现MODS,两者比较差异有统计学意义(χ2=9.87,P<0.01)。结论TNF-α及IL-6参与了脑出血后的发生、发展病理生理过程,并具有很高的预警价值。
Objective To investigate the dynamic changes of serum tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in patients with acute cerebral hemorrhage complicated with systemic inflammatory response syndrome (SIRS) Methods A total of 127 patients with acute cerebral hemorrhage were divided into SIRS group (n = 60) and non-SIRS group (n = 67). The venous blood was drawn from the fasting point at 24 h and 3, 7 and 14 d respectively. Serum TNF-α, IL-6 levels were observed. The morbidity and mortality of multiple organ dysfunction syndrome (MODS) in both groups were observed. Results The levels of TNF-α in SIRS group were significantly different at different time points (P <0.01). The levels of TNF-α in SIRS group were significantly higher than those in SIRS group at different time points (P <0.01) At the time point, there was significant difference between the two groups (P <0.01). The levels of IL-6 in the SIRS group were significantly higher than those in the non-SIRS group (P <0.01) (33/60), while the mortality rate of non-SIRS patients was only 7.46% (5/67), with significant difference between the two groups (χ2 = 11.39, P <0.01). In the SIRS group, 36% (22/60) showed MODS. MODS was found in 4.48% (3/67) of non-SIRS patients. The difference was statistically significant (χ2 = 9.87, P <0.01). Conclusion TNF-α and IL-6 are involved in the pathogenesis of intracerebral hemorrhage and develop pathophysiological processes with high early warning value.