CAJ | 학술논문

目的：探讨重型脑损伤患者血清TNF-α和NSE水平变化及其临床意义。方法选取本院2008年至2013年重型颅脑损伤患者89例（其中死亡11例），应用电化学发光发检测血清TNF-ɑ和NSE水平，分析其与临床病情变化和转归的关系。结果存活组和死亡组的TNF-ɑ和NSE与对照组比较，P<0.05；TNF-ɑ和NSE死亡组升高较存活组明显，NSE在第5天起持续升高，第7天也无明显降低；TNF-ɑ第1～2天就明显升高，两组第5～7天开始下降趋势；不同GCS患者比较：两组TNF-ɑ总体比较，差异有统计学意义（P<0.05），NSE差异无统计学意义（P>0.05）；不同预后组TNF-ɑ和NSE变化比较：两组TNF-ɑ总体比较，差异有统计学意义（P<0.05），NSE总体比较差异无统计学意义（P>0.05）。结论血清TNF-ɑ和NSE参与了重型脑损伤的病理生理过程，可能在继发性脑损伤中起重要作用，两个项目联检对于早期评估脑损伤的严重程度及判断预后有重要意义。
목적：탐토중형뇌손상환자혈청TNF-α화NSE수평변화급기림상의의。방법선취본원2008년지2013년중형로뇌손상환자89례（기중사망11례），응용전화학발광발검측혈청TNF-ɑ화NSE수평，분석기여림상병정변화화전귀적관계。결과존활조화사망조적TNF-ɑ화NSE여대조조비교，P<0.05；TNF-ɑ화NSE사망조승고교존활조명현，NSE재제5천기지속승고，제7천야무명현강저；TNF-ɑ제1～2천취명현승고，량조제5～7천개시하강추세；불동GCS환자비교：량조TNF-ɑ총체비교，차이유통계학의의（P<0.05），NSE차이무통계학의의（P>0.05）；불동예후조TNF-ɑ화NSE변화비교：량조TNF-ɑ총체비교，차이유통계학의의（P<0.05），NSE총체비교차이무통계학의의（P>0.05）。결론혈청TNF-ɑ화NSE삼여료중형뇌손상적병리생리과정，가능재계발성뇌손상중기중요작용，량개항목련검대우조기평고뇌손상적엄중정도급판단예후유중요의의。
Objective To investigate the change of serum TNF-ɑ and NSE in severe brain injury patient and its clinical significance. Methods 89 cases (11 cases died) with severe brain injury were selected in our hospital from 2008 to 2013. The TNF-ɑand NSE level in serum were detected by chemiluminiscence method. The relationship between the change of TNF-ɑ and NSE level and clinical condition was analyzed. Results TNF-ɑ and NSE in death group were significantly increased than those in survival group. NSE continued to rise at fifth day, and did not reduce at seventh day. TNF-ɑincreased significantly in 1~2 days and declined in 5~7 days. There was statistically significant difference between the two defer-ent GCS groups in TNF-ɑ(P<0.05), and no significant difference in NSE (P>0.05). There was statistically significant difference between the two defer-ent prognosis groups in TNF-ɑ(P<0.05), and no significant difference in NSE (P>0.05). Conlusion TNF-ɑand NSE were played an important role in the early assessment of severity and prognosis of brain injury.