外伤性脑损伤患者脑脊液及血清Nogo―A基因IL―1β及IL―6表达意义.docVIP

外伤性脑损伤患者脑脊液及血清Nogo―A基因IL―1β及IL―6表达意义 　　[摘要] 目的 分析外伤性脑损伤（TBI）患者脑脊液及血清Nogo-A基因、白细胞介素1β（IL-1β）及白细胞介素6（IL-6）的表达。 方法 选取2012年10月～2015年5月江苏大学附属武进医院及江苏省宜兴市人民医院收治的70例TBI患者，按照格拉斯哥昏迷评分（GCS）分将其为轻度组（n = 26）、中度组（n = 21）及重度组（n = 23），分别于入院第1、4、7、10天采集其脑脊液及静脉血，比较各组患者脑脊液及血清Nogo-A mRNA、Nogo-A蛋白、IL-1β及IL-6表达的差异。 结果 随着伤情的加重及时间的增加，TBI患者脑脊液及血清中Nogo-A mRNA表达水平、Nogo-A蛋白浓度、IL-1β、IL-6均呈现上升趋势，伤后第4天达到峰值，并于受伤7 d后逐步下降（P 0.05）。Pearson相关分析显示，脑脊液和血清中上述因子水平与患者的预后质量呈负相关，且差异有统计学意义（P 0.05）。 结论 随着TBI严重程度的增加，患者脑脊液、血清Nogo-A基因、IL-1β、IL-6表达均显著增加，与患者的预后呈负相关，脑脊液内Nogo-A、IL-1β、IL-6表达水平与患者病情变化更为一致。 　　[关键词] 外伤性脑损伤；脑脊液；血清；Nogo-A基因；白细胞介素1β；白细胞介素6 　　[中图分类号] R651 [文献标识码] A [文章编号] 1673-7210（2016）04（b）-0076-04 　　[Abstract] Objective To investigate the expression of Nogo-A mRNA， interleukin-1β （IL-1β）， interleukin-6 （IL-6） in cerebrospinal fluid and serum of patients with traumatic brain injury （TBI）. Methods Seventy cases of patients with TBI admitted to Wujin Hospital Affiliated to Jiangsu University and Yixing Peoples Hospital from October 2012 to May 2015 were selected. Based on Glasgow coma scoring （GCS）， the patients were divided into three groups： mild group （n = 26）， medium group （n = 21） and severe group （n = 23）. The cerebrospinal fluid samples and venous blood were collected at 1， 4， 7， 10 days after admission respectively. The concentrations of Nogo-A mRNA， Nogo-A protein， IL-1β and IL-6 in cerebrospinal fluid and serum in each group were compared. Results With the increase of the injury severity and time， the concentrations of Nogo-A mRNA， Nogo-A protein， IL-1β and IL-6 in cerebrospinal fluid and serum of patients with TBI showed a rising trend， which reached the peak at 4 days after injury， and they gradually decreased after injury for 7 days （P 0.05）. Pearson correlation analysis showed that the levels of indexes above in cerebrospinal fluid and serum were negatively correlated with the prognosis of TBI patients， and the differences were statistically significant （P 0.05）. Conclusion With the incr