Cytokine levels in cerebrospinal fluid and delayed ischemic deficits in patients with aneurysmal subarachnoid hemorrhage
Cytokine levels in cerebrospinal fluid and delayed ischemic deficits in patients with aneurysmal subarachnoid hemorrhage
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DOI：
10.3346/jkms.2001.16.6.774
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发表时间：
2001-12-01
影响因子：
4.5
通讯作者：
Jeon, BC
中科院分区：
文献类型：
--
作者：
Kwon, KY;Jeon, BC
蛛网膜下腔出血（SAH）可引起炎症反应，并可能导致缺血性脑损伤。脑功能障碍和迟发性缺血症状的发病机制仍然很难理解，尽管广泛的调查，这样的反应。SAH后中枢神经系统中细胞因子的产生及其与临床结局的关系几乎没有研究。本研究旨在探讨蛛网膜下腔出血（SAH）后脑脊液中IL-1 β、IL-6和TNF-α水平是否升高，并与迟发性缺血性损害的发生和临床结局相关。19例蛛网膜下腔出血患者和12例对照志愿者为研究对象。入院时采集脑脊液样本，用酶联免疫吸附试验测定每种细胞因子的水平。蛛网膜下腔出血患者入院时IL-1 β和TNF-α水平升高。神经系统状态差的患者显示出高水平的IL-1 β和IL-6。迟发性缺血性脑损伤患者血清IL-6水平升高。我们认为，脑脊液中IL-6水平升高的蛛网膜下腔出血患者入院时可以预测迟发性缺血功能障碍的高风险。
Subarachnoid hemorrhage (SAH) induces an inflammatory reaction and may lead to ischemic brain damage. The pathogenesis of brain dysfunction and delayed ischemic symptoms remain difficult to understand despite extensive surveys of such reactions. Cytokine production in the central nervous system following SAH and its relation with clinical outcome have hardly been studied. This study was aimed to determine whether the levels of IL-1 beta, IL-6 and TNF-alpha in the initial cerebrospinal fluid would increase following aneurysmal SAH, and be related with development of delayed ischemic deficit and clinical outcome. Nineteen patients suffering from aneurysmal SAH and 12 control volunteers were the subjects in this study. Cerebrospinal fluid samples were obtained on admission and the levels of each cytokine were determined with enzyme-linked immunosorbent assay. Patients with aneurysmal subarachnoid hemorrhage showed elevated levels of IL-1 beta, and TNF-alpha on admission. The patients with poor neurological status showed high levels of IL-1 beta, and IL-6. The patients who developed delayed ischemic deficit had high level of IL-6. We suggest that elevated level of IL-6 in cerebrospinal fluid of patients with aneurysmal SAH on admission can predict the high risk of delayed ischemic deficit.