创伤性颅脑损伤论文：颅脑外伤发热患者血清α-MSH及TNF-a含量的变化及其临床意义.docVIP

创伤性颅脑损伤论文：颅脑外伤发热患者血清α-MSH及TNF-a含量的变化及其临床意义 【中文摘要】创伤性颅脑损伤（TBI）是临床常见的急重症，尤其是重型颅脑损伤，其致死、致残率高，是临床关注的重点。颅脑外伤时经常会引起发热，发热会导致颅脑损伤加重，病程延长，影响预后。α-黑色素细胞刺激素（α-MSH）是一种内源性制冷源，通过监测创伤性颅脑损伤患者发热前后血清α-黑色素细胞刺激素（α-MSH）和炎症因子肿瘤坏死因子（TNF-a）的变化，探讨α-黑色素细胞刺激素（α-MSH）和发热的关系。方法：病例组为创伤性颅脑损伤发热患者30例，正常健康人20例。于患者入院时及发热后分别抽取肘静脉血分离血清后采用酶联免疫吸附双抗体夹心（ELISA）法分别检测颅脑外伤患者发热前后的血清α-MSH和TNF-a水平。再按存活和死亡将发热组患者分成两组，比较两组间的差别。最后进行统计学分析。结果：(1)：实验组颅脑外伤患者血清α-MSH含量均显著低于对照组（P均＜0.01）(2)：实验组颅脑外伤患者血清TNF-a含量均显著高于对照组（P均＜0.01）(3)：实验组颅脑外伤患者发热前后血清α-MSH的含量差异有统计学意义（P＜0.01），血清α-MSH和TNF-a呈正相关。（4）颅脑外伤患者发热后血清α-MSH水平显著高于发热前，比较有显著差异（P＜0.05或P＜0.01），而TNF-a水平显著高于发热前水平，比较有显著差异（P＜0.05）。（5）死亡组的颅脑外伤患者血清α-MSH水平在发热前后均低于存活组，两组比较有显著差异（P＜0.05或P＜0.01），而TNF-a水平均显著高于存活组发热前水平，比较有显著差异（P＜0.05或P＜0.01）。结论：颅脑外伤患者血清α-MSH含量降低而发热后含量升高，血清TNF-a含量升高，而且发热后上升更明显。因此,α-MSH是一种内源性的制冷源，血清α-MSH和TNF-a含量可作为判断颅脑损伤发热患者预后的敏感指标之一。 【英文摘要】:Traumatic brain injury is one of the most commonly seen diseases. In particular,severe brain injury threat human life and lead to very high mortality rate and disabilityrate which is a clinical research focus. To detect the variation of theα-MSH and TNF-ain the brain of fever after brain injury .This research studies discuss the relationbetween fever andα-MSH in the brain of injury.Methods:30 patients with fever after brain injury,20 person were normal healthy.we observedthe changes ofα-MSH and TNF-a after the patients with injury have a fever whenextracted venous biood and compared them with normal persons.After the serumseparated,enzyme-linked immunosorbent double antibody sandwich method ( ELISA )was applied to evaluate the levels ofα-MSH and TNF-a in the brain of fever after braininjury. In the end, we drew a conclution through statistical analysis.Results:（1）The serumα-MSH level in the brain of fever after brain injury were muchlower than the control group（P0. 01）.（2）The serum TNF-a level in the brain of fever after brain injury were muchhigher than the control group（P0. 01）.(3) There was significant difference at normal temperature and ab