CAJ | 학술논문

目的：探讨肿瘤坏死因子-α（TNF-α）、IL-6在重症颅脑损伤后心肌功能损害发生过程中的作用。方法以2009年2月至2012年5月在该院急诊科就诊，符合重症颅脑损伤的诊断标准，格拉斯哥昏迷评分（GCS）≤8分，除外合并其他部位损伤及在急诊科内死亡的患者为观察对象，共65例，在抢救治疗的同时抽血化验肌酸激酶同工酶（CK-MB）、心肌肌钙蛋白 T（cTnT）、TNF-α、IL-6，检验结果与对照组进行比较，并对观察组病例的检验结果进行相关性分析。结果观察组心肌功能检验结果：CK-MB（198．63±37．72）U／L，cTnT（548．17±49．58）pg／mL；损伤因子检验结果：TNF-α（39．93±18．88）ng／mL，IL-6（469．61±73．66）ng／mL，与对照组同类数据比较，差异有统计学意义（P ＜0．01）。观察组 CK-MB 与 TNF-α、IL-6比较，其 r＞0．9114；cTnT与 TNF-α、IL-6比较，r＞0．9421，差异均有统计学意义（P ＜0．01），呈显著正相关。结论 TNF-α和 IL-6参与了重症颅脑损伤后急性心肌功能损害的发生、发展过程，抑制它们在血液中的高浓度表达，或有可能减轻颅脑损伤后心肌功能损害的程度。
목적：탐토종류배사인자-α（TNF-α）、IL-6재중증로뇌손상후심기공능손해발생과정중적작용。방법이2009년2월지2012년5월재해원급진과취진，부합중증로뇌손상적진단표준，격랍사가혼미평분（GCS）≤8분，제외합병기타부위손상급재급진과내사망적환자위관찰대상，공65례，재창구치료적동시추혈화험기산격매동공매（CK-MB）、심기기개단백 T（cTnT）、TNF-α、IL-6，검험결과여대조조진행비교，병대관찰조병례적검험결과진행상관성분석。결과관찰조심기공능검험결과：CK-MB（198．63±37．72）U／L，cTnT（548．17±49．58）pg／mL；손상인자검험결과：TNF-α（39．93±18．88）ng／mL，IL-6（469．61±73．66）ng／mL，여대조조동류수거비교，차이유통계학의의（P ＜0．01）。관찰조 CK-MB 여 TNF-α、IL-6비교，기 r＞0．9114；cTnT여 TNF-α、IL-6비교，r＞0．9421，차이균유통계학의의（P ＜0．01），정현저정상관。결론 TNF-α화 IL-6삼여료중증로뇌손상후급성심기공능손해적발생、발전과정，억제타문재혈액중적고농도표체，혹유가능감경로뇌손상후심기공능손해적정도。
Objective To investigate the effects of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)on acute myocardial functional lesion after severe craniocerebral injury.Methods Sixty five examples with severe craniocerebral injury are collected in the 253th hospital of PLA from February in 2009 to May in 2012,of whom glasgow coma scale was low or equal to 8 points.They are examined creatine kinase-MB(CK-MB),cardiac troponin T(cTnT),TNF-αand IL-6 for correlative analysis while they are emer-gency treated at the same time.Results The myocardial function of the observe group examined results:CK-MB(198.63±37.72) U/L,cTnT(548.17±49.58)pg/mL;injury factors examined results:TNF-α(39.93± 18.88)ng/mL,IL-6(469.61 ±73.66)ng/mL.It both has evidently difference between the control group and the observe group and has obviously correlation between the my-ocardial function and injury factors of the observe group (P <0.01),and they were positively correlated.Compared TNF-α,IL-6 in observe group,CK-MB(r>0.911 4)and cTnT(r>0.942 1)had statistically significant difference.Conclusion TNF-αand IL-6 all participate in the process of the acute myocardial functional lesion after severe craniocerebral injury.The inchoate interference and treatment against TNF-αand IL-6 are possible to have inhibited the high expression of TNF-αand IL-6 in the blood and to improve the myocardial functional lesion after severe craniocerebral injury.