CAJ | 학술논문

目的：揭示和比较血清C-反应蛋白、白介素-1β、白介素-6、肿瘤坏死因子-α浓度对脑出血急性期早期神经功能恶化的预测价值。方法选取86例急性基底节区出血患者作为病例组和86例健康体检者作为对照组。记录脑出血患者入院时血肿量、脑室出血、NIHSS评分及早期神经功能恶化等临床资料。采用ELISA法测定血清C-反应蛋白、白介素-1β、白介素-6、肿瘤坏死因子-α浓度。统计分析这些炎性因子对早期神经功能恶化的预测价值。结果经独立样本t检验，病例组（或脑室出血患者或早期神经功能恶化患者）血清C-反应蛋白、白介素-1β、白介素-6、肿瘤坏死因子-α浓度均较对照组（或非脑室出血患者或非早期神经功能恶化患者）明显增高（均P<0.05）。行Pearson相关检验，入院时血肿量及NIHSS评分与血清C-反应蛋白、白介素-1β、白介素-6、肿瘤坏死因子-α浓度均显著正相关性（均P<0.05）。RO C曲线分析显示，血清C-反应蛋白、白介素-1β、白介素-6、肿瘤坏死因子-α浓度对急性期早期神经功能恶化均有显著预测价值，且它们的曲线下面积比较，差异均无统计学意义（均P>0.05）。结论 C-反应蛋白、白介素-1β、白介素-6、肿瘤坏死因子-α可能参与脑出血急性期早期神经功能恶化的炎症反应过程，临床检测这些因子可更好预测早期神经功能恶化的发生。
목적：게시화비교혈청C-반응단백、백개소-1β、백개소-6、종류배사인자-α농도대뇌출혈급성기조기신경공능악화적예측개치。방법선취86례급성기저절구출혈환자작위병례조화86례건강체검자작위대조조。기록뇌출혈환자입원시혈종량、뇌실출혈、NIHSS평분급조기신경공능악화등림상자료。채용ELISA법측정혈청C-반응단백、백개소-1β、백개소-6、종류배사인자-α농도。통계분석저사염성인자대조기신경공능악화적예측개치。결과경독립양본t검험，병례조（혹뇌실출혈환자혹조기신경공능악화환자）혈청C-반응단백、백개소-1β、백개소-6、종류배사인자-α농도균교대조조（혹비뇌실출혈환자혹비조기신경공능악화환자）명현증고（균P<0.05）。행Pearson상관검험，입원시혈종량급NIHSS평분여혈청C-반응단백、백개소-1β、백개소-6、종류배사인자-α농도균현저정상관성（균P<0.05）。RO C곡선분석현시，혈청C-반응단백、백개소-1β、백개소-6、종류배사인자-α농도대급성기조기신경공능악화균유현저예측개치，차타문적곡선하면적비교，차이균무통계학의의（균P>0.05）。결론 C-반응단백、백개소-1β、백개소-6、종류배사인자-α가능삼여뇌출혈급성기조기신경공능악화적염증반응과정，림상검측저사인자가경호예측조기신경공능악화적발생。
Objective To investigate and compare predictive values of serum C-reactive protein(CRP),interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)concentrations for early neurologic deterioration (END)after intracerebral hemorrhage. Methods 86 patients with acute basal ganglia hemorrhage were recruited as case group,and 86 healthy individuals from physical examinees were chosen as control group. Clinical materials of intracerebral hemorrhage patients including on admission hematoma volume,intraventricular hemorrhage,and NIHSS score as well as END were recorded. Serum CRP,IL-1β,IL-6 and TNF-α concentrations were measured by ELISA. Predictive values of these biomarkers for END were analyzed statistically. Results Using independent-samples t test,serum CRP,IL-1β, IL-6 and TNF-α concentrations were statistically significantly higher in treatment group than in control group,in patients with intraventricular hemorrhage than in those without intraventricular hemorrhage,and in patients with END than in those without END(all P<0.05). Using Pearson test,on admission hematoma volume and NIHSS score were highly associated with serum CRP,IL-1β,IL-6 and TNF-αconcentrations(all P<0.05). ROC analysis showed that serum CRP,IL-1β, IL-6 and TNF-αconcentrations statistically significantly predicted END,and when area under curves of these biomarkers was compared with each other,these differences were not statistically significant(all P>0.05). Conclusions CRP,IL-1β, IL-6 and TNF-αmay be involved in inflammatory response of END in acute phase of intracerebral hemorrhage,and clinical determination of these biomarkers in serum can markedly predict occurrence of END.