The Value Of Interleukin-6 And Interleukin-8 In Cerebrospinal Fluid In The Preoperative Evaluation And Prediction Of Surgical Effect In Secondary Normal Pressure Hydrocephalus

Objective:To investigate the predictive value of interleukin-6 and interleukin-8 in cerebrospinal fluid(CSF)in preoperative evaluation and surgical result of shunting in secondary normal pressure hydrocephalus.Methods:39 patients with secondary hydrocephalus and 7 patients with idiopathic hydrocephalus were evaluated on admission,after CSFTT and after operation.The assessment included MMSE score,action ability assessment,micro state of consciousness assessment(Some patients had disturbance of consciousness when they were admitted to hospital.MMSE and action ability assessment were replaced by micro consciousness assessment),urinary incontinence score and KPS score.The levels of IL-1 β,IL-6,IL-8 and TNF-α in cerebrospinal fluid of lumbar puncture tapping test were detected.Statistical analysis of the relationship between interleukin level and preoperative evaluation and prognosis.Results:1.39 patients with sNPH were evaluated on admission and after CSFTT.Cerebrospinal fluid analysis was performed.Preoperative evaluations were positive in 28 cases(71.8%)and the negative in 11 cases(28.2%).The levels of IL-6 in CSF were 26.9 ± 32.3(pg / ml)and 5.7 ± 3.7(pg/ ml),P = 0.002.The levels of IL-8 in CSF were 118.0 ± 71.3(pg / ml)and 37.5 ± 26.2(pg / ml),P = 0.000;.The levels of L-1 β in CSF were 6.8 ± 2.5(pg / ml)and 9.6 ± 2.7(pg / ml),P = 0.022.The CSF TNF-α levels in the effective group and the ineffective group were 7.5 ± 5.5(pg / ml)and 7.5 ± 4.8(pg / ml)respectively(P = 0.995).The difference was not statistically significant.2.35 of 39 sNPH patients were operated.Postoperative evaluation was positive in 25 cases(71.4%)and negative in 10 cases(28.6%).The levels of IL-6 in CSF were 27.1 ± 33.1(pg / ml)and 5.1 ± 1.4(pg / ml),P = 0.003.The levels of IL-8 in CSF were 127.5 ± 68.3(pg / ml)and 35.9 ± 28.6(pg / ml),P = 0.000.The levels of L-1 β in CSF were 6.4 ± 2.9(pg / ml)and 9.6 ± 4.1(pg / ml),P = 0.015.The CSF TNF-α levels in the positive group and the negative group were 7.7 ± 5.7(pg / ml)and 7.0 ± 3.5(pg / ml)respectively(P = 0.632).3.39 patients with sNPH were divided into conscious disorder group and non conscious disorder group according to their state of consciousness.The relationship between the level of interleukin and the two groups was analyzed.The levels of IL-8 in cerebrospinal fluid were 136.6 ± 71.5(pg / ml)in conscious disorder group and 59.8 ± 50.6(pg / ml)in non conscious disorder group(P = 0.000).There was no significant difference in IL-1 β,IL-6 and TNF-α in CSF between the two groups(P > 0.05).4.46 NPH patients were divided into the iNPH group and the sNPH group according to their pathogeny.The difference of IL level in CSF between the two groups was analyzed.The levels of IL-6 and IL-8 in CSF were 4.0 ± 24.8(pg / ml)and 20.9 ± 29.0(pg / ml),P = 0.001,41.2 ± 24.8(pg / ml)and 95.3 ± 71.7(pg / ml),P = 0.056,respectively.There was no significant difference in IL-1 β and TNF-α in CSF between the two groups(P > 0.05).Conclusion:1.CSF IL-6 and IL-8 levels in preoperative positive group were significantly higher than the levels in preoperative negative group in sNPH patients.Cerebrospinal fluid IL-6 or IL-8 has a good value of preoperative evaluation.2.CSF IL-6 and IL-8 levels in postoperatively positive group were significantly higher than the levels in postoperative negative group in sNPH patients.The increase of IL-6 or IL-8 in cerebrospinal fluid may predict better surgical outcome.3.Patients in sNPH with high CSF IL-6 and IL-8 levels often need shunt surgery.It predicts that shunt operation may be effective.