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目的:动态监测急性脑出血患者血清炎症因子和氧化应激产物水平,探讨其与患者病情及预后的关系。方法:采用双抗体夹心酶联免疫吸附法(ELISA法)测定150例急性脑出血患者(病例组)和120例健康志愿者(对照组)发病24 h内、3 d、7 d及14 d时血清炎症因子白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α),采用黄嘌呤氧化酶法(XTO)和硫代巴比妥酸法(TBA)测定两组的血清氧化应激产物超氧歧化酶(SOD)和丙二醛(MDA)水平,并分析血液炎症因子与氧化应激产物与患者病情及预后的关系。结果:病例组血清IL-6、TNF-α、SOD及MDA水平高于对照组,并在发病后7d各指标水平达到最高,发病后14d各指标水平低于发作≤24 h,差异有统计学意义(P<0.05)。大量出血组血清IL-6、TNF-α、SOD及MDA水平最高,中量出血组其次,小量出血组各指标水平最低,差异均有统计学意义(P<0.05)。重型组血清IL-6、TNF-α、SOD及MDA水平均最高,中型组其次,轻型组各指标水平最低,差异均有统计学意义(P<0.05)。结论:动态监测急性脑出血患者血清炎症因子及氧化应激产物水平有助于准确判断患者的病情及评估预后,临床有重要参考价值。
OBJECTIVE: To dynamically monitor serum levels of inflammatory cytokines and oxidative stress products in patients with acute cerebral hemorrhage and investigate their relationship with disease status and prognosis. Methods: The clinical data of 150 patients with acute cerebral hemorrhage (case group) and 120 healthy volunteers (control group) were measured within 24 hours, 3 days, 7 days and 14 days by ELISA. Serum levels of inflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were measured by Xanthinol method and thiobarbituric acid method (TBA) Oxidative stress products superoxide dismutase (SOD) and malondialdehyde (MDA), and to analyze the relationship between blood inflammatory factors and oxidative stress products and patient’s condition and prognosis. Results: Serum levels of IL-6, TNF-α, SOD and MDA were higher in the case group than in the control group, and reached the highest level at the 7th day after onset. The levels of IL-6, TNF- Significance (P <0.05). The levels of serum IL-6, TNF-α, SOD and MDA in the massive bleeding group were the highest, while those in the middle and small bleeding group were the lowest (P <0.05). The levels of serum IL-6, TNF-α, SOD and MDA in the severe group were the highest, while those in the middle group and the light group were the lowest (all P <0.05). Conclusion: The dynamic monitoring of serum levels of inflammatory cytokines and oxidative stress products in patients with acute cerebral hemorrhage helps to accurately determine the patient’s condition and evaluate the prognosis, and has important clinical value.