| It has been proved that central nervous system can generate a large amount of inflammatory cytokines such as IL-1, IL-6when traumatic brain injury (TBI) occurs, especially when severe traumatic brain injury (sTBI) occurs. These inflammatory cytokines play an important role in secondary inflammation and neuronal damage after TBI.In this paper, joint dynamic detection of IL-1β and IL-6in serum and cerebrospinal fluid are conducted to know the variation of the inflammatory cytokines in the varying degrees and different stages of brain injury; to study the relationship between the inflammatory cytokines IL-1β IL-6and brain injury.Based on glasgow coma scoring (GCS) method, the patients were divided into four groups:mild group, medium group, severe group, and normal control group. Take the peripheral venous blood and cerebrospinal fluid samples after the injury occurred one day,2days,3days,5days,7days and14days respectively. Double antibody sandwich ELISA method was used to detect the IL-1β and IL-6contents in serum and cerebrospinal fluid. Surgical treatment was conducted to the severe group. And during the surgery, intracranial pressure monitoring probe was placed under the subdural to monitor intracranial pressure.The study found that for all patients the IL-1β, IL-6in both serum and cerebrospinal fluid are increased after injury; For the severe group, IL-1β in cerebrospinal fluid got its peak in the first day after injury, and in the fifth day the second peak appeared, well, IL-1β in serum peaked in the fifth day, and was still higher than normal after14days. For the medium and mild group, IL-1β in cerebrospinal fluid reached a peak in the next day after injury, in serum reached its peak in the fifth day; and decreased to normal levels in the14th day after injury. IL-6in the cerebrospinal fluid of severe group reached the peak in the first postoperative day. After that, there are two possibilities:one is that it gradually declined and only a single peak occurred for most severe patients, another one is, for a small part of severe patients, it increased again in the fifth postoperative day and double peaks appeared. IL-6in serum increased rapidly, reached the peak in first day after injury, and then it decreased gradually, but when14days had passed after injury it was still higher than the normal levels. IL-6in both cerebrospinal fluid and serum of medium and mild groups reached the peak in the next day after injury, and decreased to the normal levels in14days after the injury. The content of IL-1β, IL-6in serum and cerebrospinal fluid of severe group were closely related to brain pressure changes, and they were very high for those dead patients, and dropped little over time.The preliminary conclusions of this paper:1. Increased concentrations of IL-1β, IL-6in cerebrospinal fluid and serum in different periods after brain injury showed that inflammatory factors IL-1β, IL-6participated in the pathophysiological process of early brain injury. IL-1β, IL6in cerebrospinal fluid and serum in different periods after varying degrees of brain injury can indicate the dynamic change of secondary brain damage. So the measurements of IL-1β, IL-6in cerebrospinal fluid and serum after brain injury is significant to get the clinical diagnosis and judgment of injury severity, assess prognosis and guide different brain injury treatment, to improve the level of brain injury treatment.2. The experiments show that IL-1β and IL-6levels in the cerebrospinal fluid and serum is positively related to the severity of brain injury. The higher of IL-1β with IL-6content showed more serious traumatic brain injury and the worse the prognosis of patients. Patients in severe group with "Twin Peaks" for both IL-1β and IL-6appear poor prognosis. Combined with follow-up observation of this group of patients, there is a significant difference for the prognosis of patients between the IL-6presents "Twin Peaks" and a single peak. That IL-1β and IL-6levels in the cerebrospinal fluid and serum are still above normal levels14days after surgery is considered because these patients’blood-brain barrier is severely damaged, and recovery is slow. It provides some basis for guiding clinical drug therapy, and prevents effectively secondary brain injury. This experiment confirmed the IL-1β and IL-6level in the cerebrospinal fluid and serum of patients of the death group is very high and keeping in the high level.3. IL-1β, IL-6in the cerebrospinal fluid is higher than that in the peripheral blood. That the increased levels of IL-1β, IL-6is mainly in the cerebrospinal fluid may probably be the most important reason to lead to the inflammatory reactions and nerve damage of the post-traumatic local brain tissue. Therefore, to reflect the changes in the brain injury, IL-1β, IL-6in cerebrospinal fluid is more sensitive and specific than those in serum.4. IL-1β and IL-6in both cerebrospinal fluid and serum is positively correlated with intracranial pressure for the patients in severe injury group after surgery of TBI. It showed that IL-1β and IL-6may be involved in the secondary cerebral edema and the intracranial hypertension occurrence and development after TBI.5. Compared with the single detection, that combined detection of IL-1β and IL-6in both serum and cerebrospinal fluid will be more comprehensive and accurate to express the brain injury. The combined detection reflect the severity of the injury and the severity of the evolution and could make some judgments on the prognosis. It is a new and more reliable approach to improve the accuracy of clinical prediction.The innovation of this paper is as follows:1. Found out the dynamic change of IL-1, IL-6in varying degrees of the brain injury and its relationship with prognosis using dynamic detection of the expression of IL-1, IL-6in serum and cerebrospinal fluid during different time after TBI.2. Figured out the function of combined detection method in the evaluation of the degree of brain injury and prognostic by comparing IL-1β and IL-6levels in both serum and cerebrospinal fluid, explored their synchronization expression after surgery, and provided a reference for clinical diagnosis and treatment.3. Multi-temporal point of dynamic detection of IL-1,IL-6content in cerebrospinal fluid.4. Investigated the relationship between IL-1, IL-6content and intracranial pressure when sTBI occurred.Dynamic joint detection of IL-1β and IL-6levels can be used as an important indicator of clinical judgment extent and prognosis of traumatic brain injury in the cerebrospinal fluid content with traumatic brain injury in interleukin. But what is the mechanism? Can the measurements of cerebrospinal fluid and serum cytokines adequately represent the brain parenchyma? Studies between interleukin and brain injury need to be further explored. |
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