颅脑损伤患者急性期白细胞介素-1β及细胞间黏附分子-1水平的变化

摘要

目的：分析颅脑损伤患者急性期血清中白细胞介素‐1β（interleukin‐1β，IL‐1β）及细胞间黏附分子‐1（ICAM‐1）的变化及临床意义。方法选取我院2012‐02—2014‐08收治的于发病24 h 内入院的颅脑损伤患者82例，按损伤的程度分组，轻、中型颅脑损伤组44例，重型颅脑损伤组38例，同时选取同期健康体检人员40例为健康对照组，采用酶联免疫吸附试验检测颅脑损伤患者入院时、入院后24、72 h 和7 d 时的血清 IL‐1β及 ICAM‐1水平，并检测健康对照组的血清 IL‐1β及 ICAM‐1水平作对照。结果各颅脑损伤组患者入院时血清 IL‐1β及 ICAM‐1水平均较健康对照组升高，差异有统计学意义（P ＜0.05）；IL‐1β水平在颅脑损伤患者入院时、入院后24 h 处于上升趋势，入院后72 h 时达高峰，后又逐渐下降；ICAM‐1水平在患者入院时有所升高，在入院24 h 时达高峰，持续72 h 时逐渐降低；重型颅脑损伤组患者血清 IL‐1β及 ICAM‐1水平在各个时段均高于轻、中型颅脑损伤组，差异均有统计学意义（P＜0.05或0.01）。结论血清 IL‐1β及 ICAM‐1水平可反映颅脑损伤患者的炎症损伤程度，其水平变化与病情程度有密切关系。急性期监测这些指标的水平对颅脑损伤患者的病情评估具有重要的指导意义。%Objective To analyze the changes of the serum interleukin 1β (IL‐1β) and intercellular adhesion molecule‐1 (ICAM‐1) levels in patients with craniocerebral injury and to explore corresponding clinical significance .Methods Eighty‐two patients with craniocerebral injuries within 24 hours of onset ,were recruited in our hospital from February 2012 to August 2014 ,who were divided into mild‐moderate group (n= 44) and severe group (n= 38) according to the condition of injuries ,and 40 healthy volunteers were considered as controls during the same period .We detected serum IL‐1β and ICAM‐1 levels by en‐zyme‐linked immunosorbent assay on admission ,at 24 hours ,72 hours and 7 days after admission in all participants ,and ana‐lyzed the comparative differences among all groups .Results The serum IL‐1β and ICAM‐1 levels in each craniocerebral injury group were markedly increased with statistical differences (P < 0 .05) ,when compared with control group .The serum IL‐1βlevels in craniocerebral injury patients imposed increase tendency on admission and at 24 hours after admission ,peaked at 72 hours after hospitalization ,and then gradually decreased .While ICAM‐1 levels increased on admission and peaked at 24 hours after admission ,which gradually decreased after 72‐hour continuous peakedness .Furthermore ,the severe group had higher levels of the serum IL‐1β and ICAM‐1 at each period compared with mild‐moderate group ,and the differences were statistically significant (P< 0 .05 or 0 .01) .Conclusion The serum IL‐1β and ICAM‐1 levels may reflect the degree of inflammation in craniocerebral injury patients ,which were closely related to the severity of disease .As noted ,monitoring these indicators at a‐cute phase have an important effect on condition evaluation in patients with craniocerebral injuries .