| Objective:To explore the possible mechanism of acute brain injury with systemic inflammatory response syndrome and multiple organ dysfunction.This item dynamically observed the regulation of neutrophilic granulocyte,platelets,tumor necrosis factor alpha(TNF-α),Interleukin-6(IL-6) and c-reaction protein(CRP) of patients with normal control,simple acute craniocerebral injury,acute craniocerebral injury accompanied with SIRS and acute craniocerebral injury With MODS, so as to investigate the significance of the mechanism in the acute craniocerebral injury 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 acute craniocerebral injury.Methods:The patients resource is 96 cases of patients with acute craniocerebral injury with the onset within 2 days in our department of neurosurgery from June, 2008 to November,2009, aged 42.16±3.61.They were dixided into 3 groups:①acute simple craniocerebral injury group 42 cases,②acute craniocerebral injury accompanied with SIRS group 34 cases,③cute craniocerebral injury accompanied with MODS group 20 cases.30 cases(age 42.32±4.76) normal heathy human adopted as control group. All cases had no surgery, 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 heart, liver, lung or kidney, malignant tumor or immunology system disease. All cases and the persons in control group are taken 6ml of venous blood at morning without food within 2 days of onset.The blood is placed in 3 normal test tubes.The first one is tested by blood routine for neutrophilic granulocyte and platelets. The second one is for 1 hour at room temperature, then was centrifuged for 10 minutes at 3000r/min, the up layer serum was taken and tested by double antibody sandwich (ELISA) for tumor necrosis factor alpha(TNF-a) and Interleukin-6(IL-6). The third one for 1 hour at room temperature, then was centrifuged for 10 minutes at 3000r/min, the up layer serum was taken and tested by immunoturbidimetry for c-reaction protein(CRP).All datas are analysed statistically by SPSS15.0 statistieal softWare, experimental datas are expressed as mean±standard deviation (X±s).T test is used for group comparison. Difference is called significance by p<0.05.Results:1. The occurrence rate of acute craniocerebral injury accompanied withSIRS was 35.42% .The occurrence rate of acute craniocerebral injury accompanied with MODS was 20.83%.The occurrence rate of MODS with acute craniocerebral injury accompanied with SIRS was 58.82%. The occurrence rate of SIRS with acute craniocerebral injury accompanied with MODS was 100%.2. The levels of neutrophilic granulocyte. platelets. tumor necrosis factor alpha(TNF-α),Interleukin-6(IL-6) and c-reaction protein(CRP) in simple acute craniocerebral injury group,acute craniocerebral injury accompanied with SIRS group and acute craniocerebral injury accompanied with MODS group was obviously higher than that in control group(P<.01), while that in acute craniocerebral injury accompanied with SIRS was obviously higher than that in in simple acute craniocerebral injury group (P<0.01), and that in acute craniocerebral injury accompanied with MODS was obviously higher than that in acute craniocerebral injury accompanied with SIRS group (P<0.01), having a proness of increasing dynamically.3. The content of granulocyte. platelets. tumor necrosis factor alpha (TNF-α),Interleukin-6(IL-6) and c-reaction protein(CRP) in the acute craniocerebral injury accompanied with MODS of various score groups (score≥9 group and score<9 group) is higher than that in the acute craniocerebral injury accompanied with SIRS group obviously(P<0.01), what's more, in patients of acute craniocerebral injury accompanied with MODS, that in severe patients(score≥9)is higher than that in mild patients (score<9)(P<0.01).4. The levels of granulocyte,platelets,tumor necrosis factor alpha (TNF-α),Interleukin-6(IL-6) and c-reaction protein(CRP) in acute craniocerebral injury accompanied with MODS who died within 3 days was obviously higher than that in survival group(P<0.01).5. Among the 5 biochemical indicators of granulocyte.platelets.tumor necrosis factor alpha (TNF-a). Interleukin-6(IL-6) and c-reaction protein (CRP), the turn of the correlativity with acute craniocerebral injury accompanied with SIRS and MODS: granulocyte> c-reaction protein (CRP)> tumor necrosis factor alpha (TNF-a)> Interleukin-6(IL-6)> platelets.Conelusion:1. acute craniocerebral injury could be accompanied with SIRS, and could be the pathological basis of MODS after acute craniocerebral injury.2. SIRS is the probable mechanism of acute craniocerebral injury accompanied with MODS. It has a high foretell value to acute craniocerebral injury accompanied with(or without) MODS of monitoring the content change of levels of granulocyte,platelets,tumor necrosis factor alpha (TNF-α),Interleukin-6(IL-6) and c-reaction protein (CRP) in patients of acute craniocerebral injury. It provides the theory basis and laboratory index to diagnose early and prevent the happens of MODS and judge the prognosis of acute craniocerebral injury.3. The levels of granulocyte,platelets,tumor necrosis factor alpha (TNF-α),Interleukin-6(IL-6) and c-reaction protein (CRP) content can become the criteria of disease degree and clinical effective in the content change of accompanied with SIRS or acute craniocerebral injury accompanied with MODS patients. It was very important for us to diagnose the patients earlier when they transfer from SIRS to MODS.4.The progress of monitoring the content change of acute craniocerebral injury, transfering from SIRS to MODS and prewarning,the most useful biochemical indicators are granulocyte, c-reaction protein (CRP) and tumor necrosis factor alpha (TNF-a).Interleukin-6(IL-6) and platelets are auxiliary diagnosis biochemical indicators, used for referring.
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