本文關(guān)鍵詞： 腦出血 炎癥細胞因子 腦水腫 白細胞介素 相關(guān)性　出處：《新鄉(xiāng)醫(yī)學院》2013年碩士論文　論文類型：學位論文

【摘要】：背景 隨著近年來國內(nèi)外學者的深入研究發(fā)現(xiàn),炎癥細胞因子白細胞介素-1、白細胞介素-2、白細胞介素-4、白細胞介素-6、白細胞介素-8、白細胞介素-10、白細胞介素-18以及TNF-α等均是介導(dǎo)腦出血之后腦水腫形成的重要炎癥因子。雖然大量的實驗與研究結(jié)果均已全面證實以上各種炎癥因子在腦出血的急性期均不同程度地參與血腫周圍腦組織水腫的發(fā)生,同時,各炎癥因子之間還存在著彼此促進、調(diào)節(jié)以及抵制的作用,但是,對于各炎癥因子與血腫周圍組織的相關(guān)性哪種炎癥因子發(fā)揮的作用、參與的程度更多、更密切、更具代表性則尚無更多的報道。因此,將通過本實驗對相關(guān)炎癥因子與血腫周圍腦組織的相關(guān)性進行研究與分析。 目的 測定腦出血患者腦血腫液和血清中的白細胞介素-4、白細胞介素-6、白細胞介素-8、白細胞介素-10的水平,探索腦水腫的發(fā)生機制；各炎癥因子水平與腦水腫的關(guān)系以及彼此間的相關(guān)性；并對炎癥因子與腦水腫的相關(guān)性以及具有代表性的炎癥因子做出進一步的明確分析,為將來的臨床治療提供一些參考依據(jù)。 方法 (1)選取2010年9月～2012年11月急性腦出血患者102例,并選取20例健康體檢者,作為健康對照組。(2)標本采集、處理和儲存。(3)腦血腫量及血腫周圍的水腫量測定。(4)炎癥因子的檢測。(5)對所有相關(guān)數(shù)據(jù)進行統(tǒng)計分析。 結(jié)果 (1)基底節(jié)區(qū)急性腦出血病患的血清之中的白細胞介素-4、白細胞介素-6、白細胞介素-8、白細胞介素-10濃度水平均明顯高于健康對照組(P0.05)；而血腫液以及靜脈血中的白細胞介素-4、白細胞介素-6、白細胞介素-8、白細胞介素-10濃度水平則無明顯差異(P0.05)。 (2)基底節(jié)區(qū)急性腦出血病患6h內(nèi)的血清之中的白細胞介素-4、白細胞介索-6、白細胞介素-8濃度水平均明顯高于健康對照組(P0.05)：而白細胞介素-10則與健康對照組無明顯差異(P0.05)。24-72h時白細胞介素-4、白細胞介素-6、白細胞介素-8則均達峰值,至3-7d時呈下降趨勢,均明顯高于健康對照組(P0.05)。 (3)基底節(jié)區(qū)急性腦出血病患在6h-7d之內(nèi)水腫量以及出血量之間呈正相關(guān),具統(tǒng)計學意義(P0.05)。 (4)白細胞介素-4、白細胞介素-6、白細胞介素-8、白細胞介素-10兩兩之間均具相關(guān)性,且.均呈正相關(guān)。 (5)白細胞介素-4、白細胞介素-6、白細胞介素-8、白細胞介素-10各炎癥因子對急性腦出血病患的腦水腫的影響以及作用強度呈現(xiàn)為白細胞介素-4白細胞介素-10白細胞介素-6白細胞介素-8。 結(jié)論 (1)急性腦出血患者體內(nèi)白細胞介素-4、白細胞介素-6、白細胞介素-8、白細胞介素-10濃度明顯高于健康對照組。 (2)急性腦出血患者6h-7d內(nèi)水腫量與出血量呈正相關(guān)。 (3)各炎癥因子對急性腦出血后腦水腫的影響強度依次為II-4IL-10IL-6 IL-8。 (4)急性腦出血病患體內(nèi)IL-4、IL-10對血腫周圍水腫量的作用較大,應(yīng)加強對抗炎因子的重視,并可以根據(jù)病患實際情況來制定不同的治療方案。
[Abstract]:Background It was found that IL - 1 , IL - 2 , IL - 4 , IL - 6 , IL - 8 , IL - 10 , IL - 18 and TNF - 偽 play an important role in the formation of brain edema after intracerebral hemorrhage . Purpose To determine the level of interleukin - 4 , interleukin - 6 , interleukin - 8 and interleukin - 10 in brain hematoma fluid and serum of patients with cerebral hemorrhage , to explore the mechanism of brain edema , the relationship between inflammatory factors and brain edema and their correlation with each other , and to provide some reference for future clinical treatment . method ( 1 ) 102 patients with acute cerebral hemorrhage from September 2010 to November 2012 were selected and 20 healthy controls were selected as healthy controls . ( 2 ) The samples were collected , treated and stored . ( 3 ) The amount of brain hematoma and edema around hematoma were measured . Results ( 1 ) The levels of IL - 4 , IL - 6 , IL - 8 and IL - 10 in serum of patients with acute cerebral hemorrhage in basal ganglia were significantly higher than those in healthy control group ( P0.05 ) , but there was no significant difference in the levels of IL - 4 , IL - 6 , IL - 8 and IL - 10 in hematoma fluid and venous blood ( P0.05 ) . ( 2 ) The levels of IL - 4 , IL - 6 and IL - 8 in serum of patients with acute cerebral hemorrhage in basal ganglia were significantly higher than those in healthy control group ( P0.05 ) . ( 3 ) There was positive correlation between the amount of edema and the amount of bleeding within 6 - 7 days of acute cerebral hemorrhage in basal ganglia region ( P0.05 ) . ( 4 ) The correlation between IL - 4 , IL - 6 , IL - 8 and IL - 10 was positively correlated . ( 5 ) The effects of IL - 4 , IL - 6 , IL - 8 , IL - 10 inflammatory factors on brain edema in patients with acute cerebral hemorrhage were presented as interleukin - 4 interleukin - 6 interleukin - 6 . Conclusion ( 1 ) The levels of IL - 4 , IL - 6 , IL - 8 and IL - 10 in patients with acute cerebral hemorrhage were significantly higher than those in healthy controls . ( 2 ) The amount of edema in 6 - 7 days of acute cerebral hemorrhage was positively correlated with the amount of hemorrhagic volume . ( 3 ) The effect of each inflammatory factor on brain edema after acute cerebral hemorrhage was II - 4IL - 10IL - 6 IL - 8 . ( 4 ) In patients with acute cerebral hemorrhage , IL - 4 and IL - 10 play a role in the amount of edema around hematoma , the importance of anti - inflammatory factors should be strengthened , and different treatment schemes can be developed according to the actual conditions of patients .

【學位授予單位】：新鄉(xiāng)醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R743.34

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