The Clinical Study Of The Acute Cerebrovascular Disease Leading To Systemic Inflammatory Response Syndrome Which Cause To Multiple Organ Disfunction Syndrome

Objective: To explore the possible mechanism of acute cerebrovascular disease leading to systemic inflammatory response syndrome(SIRS) which cause to the multiple organ disfunction syndrome(MODS) according to the diagnostic standard of SIRS in severe medicine field. This item dynamically observed the regulation of tumor necrosis factor alpha(TNF-α),Interleukin-6(IL-6) in serum of patients with simple cerebrovascular disease, cerebrovascular disease accompanied with S IRS and c erebrovascular d isease accompanied w ith MODS,so as to investigate the significance of the mechanism in the acute cerebrovascular disease from SIRS to MODS, dignostic value and clinical significance,providing theory basis and laboratory index for early preventing the happeness of MODS and judging the prognisis of cerebrovascular disease.Method:The patients resource is 76cases of patients with acute cerebrovascular disease with the onset within 3 days in our neurological medicine department from 2004.1-2004.12,age 56.75± 11.61,verified by CT or MRI. They were dixided into 3 groups: (1) acute simple cerebrovascular disease group 40 cases, (2) cerebrovascular disease accompanied with SIRS group 36 cases, (3) cerebrovascular disease accompanied with MODS group 22 cases, 20 cases ( age52.16± 13.34) normal heathy human adopted as control group. All cases had nosurgery > trauma or heart or head stroke in half a year, had no infection in 14 days, and they were not accompanied with important organ disease such as hearU liver> lung or kidney,malignant tumor or immunology system disease. All cases and the persons in control group are taken 3ml of venous blood at morning without food within 3 days of onset. The blood was placed in normal test tube for 1 hour at room temperature, then was centrifuged for 10 minutes at 3000r/min.The up layer serum was taken and stored in refrigerator at -70°C for test. TNF-a N IL-6 were tested by ELISAmethod. All datas were analysed statistically by SPSS lO.Ostatistical software.One-way analysis of variance was adopted to compare multiple sample mean and then LSD method Was adopted to compare them one by one.The means of the two sample were compared with t test.Results:l.The occurrence rate of cerebrovascular disease accompanied with SIRS was 47.37%. The occurrence rate of cerebrovascular disease accompanied with MODS was 28.95%. The occurrence rate of MODS with cerebrovascular disease accompanied with SIRS was 61.11%. The occurrence rate of SIRS with cerebrovascular disease accompanied with MODS was 100%.2. The serum level of TNF- a > IL-6 in simple cerebrovascular disease group/ cerebrovascular disease accompanied with SIRS group and cerebrovascular disease accompanied with MODS group was obviously higher than that in control group (P<0.01), while that in cerebrovascular disease accompanied with SIRS was obviously higher than that in control group (P<0.01), and that in cerebrovascular disease accompanied with MODS was obviously higher than that in cerebrovascular disease accompanied with SIRS group (P<0.01), having a proness of increasing dynamically.3. The content of TNF-a ? IL-6 in serum in the cerebrovascular disease accompanied with MODS of various score group is higher than that in the cerebrovascular disease accompanied with SIRS group obviously(P<0.01), what' s more ,in patients of cerebrovascular disease accompanied with MODS, that in severe patients (scored 9) is higher than that in mild patients (score<9) ( P<0.01) .4.The serum level of TNF- a ? IL-6 in cerebrovascular diseaseaccompanied with MODS who died within 3 days was obviously higher than that in survival group(P<0.01).Conclusion:1. Cerebrovascular disease could be accompanied with SIRS,and could be the pathological basis of MODS after cerebrovascular disease.2.SIRS is the probable mechanism of cerebrovascular diseaseaccompanied with MODS. It has a high foretell value to cerebrovascular diseaseaccompanied with (or without)MODS of monitoring the content change of serum level of TNF- a ? IL-6 in patients of cerebrovascular disease. It provides the theory basis and laboratory index to diagnose early and prevent the happens of MODS and judge the prognosis of cerebrovascular disease.3. The level of the serum TNF- a ? IL-6 content can become the criteria of disease degree and clinical effective in cerebrovascular diseaseaccompanied with SIRS or cerebrovascular diseaseaccompanied with MODS patients. It was very important for us to diagnose the patients earlier when they transfer from SIRS to MODS.