| Objective: intracerebral hemorrhage (ICH) is a common diseases of cerebrovascular disease which make a serious threat to human health,is one of strokes and it is difficult to treat.it accounts for 10% to 20% of all acute cerebrovascular disease,its morbidty mortality and disability rate are higher than other's stroke diseases. Medical conservative treatment have no new progress. However,the brain edema after intracerebral hemorrhage leads to increased illness and death. Now it is one of the hot research at home and abroad. Beside acute space-occupying effect that intracerebral hemorrhage results in,the blood components (especially prothrombin) and the secondary intracerebral ischemia are important reasons which cause brain cell death. Most scholars believe that the secondary injury of the brain tissue around the hematoma after intracerebral hemorrhage is the main reason leading to the deterioration of neurological function,the most important pathological changes is secondary cerebral edema. Reasons for the formation of brain edema is extremely complex,the release of hemoglobin after the dissolution of red blood cells in hematoma liquid and the participation of inflammatory factors may play an important role in the formation process of brain edema after intracerebral hemorrhage. Currently cytokines is considered the basic medium in the immune response,which directly or indirectly involve in the activation and infiltration of inflammatory cells. The role of cytokines in the body is extremely complex and mutual influence among the interlinkages,which form a complex cytokine network.In recent years,research found that inflammatory cytokines TNF-a, IL-1,IL-2,IL-4,IL-6,IL-8,IL-10,IL-18 is important factors in the formation of brain edema after intracerebral hemorrhage,IL-4 is a cytokine with a variety of biological functions which involves in a variety of body tissue growth, differentiation and functional regulation,it plays an important role in the immune and inflammatory responses, IL-4 can inhibit production and release of inflammatory cells and inflammatory factors,also has immunomodulatory effects,thereby reduce tissue damage. IL-6 is a multi-effect cytokines which play an important role in such processes of host defense,stress response, immune response and hematopoietic responses. It has a variety of biological effects,not only involved in immune response,blood cell formation and stress response,but also both have anti-inflammatory effects and pro-inflammatory effect, it play a dual role of neurotrophic,neuroprotective and neurotoxic on the central nervous system. IL-8 as an important neutrophil chemotactic factor,through neutrophil chemotaxis,activation and regulation of adhesion molecules,can lead to a large number of the release of oxygen free radicals, blood-brain barrier damage and brain tissue moisture increase,it is one of the important cytokines that caused cerebral edema. IL-10 is a inhibitory lymphokines,which Th2 cell secrete and inhibit Th1 cell function . IL - 10 has a strong anti-inflammatory effect,it can inhibit synthesis and release of certain cytokines,such as TNF-α,IL - 2,IL-6,IL-8,etc,and has a protective effect to brain tissue edema around the hematoma. At present a large number of experimental studies have demonstrated that a variety of inflammatory cytokines are related to brain tissue edema around the hematoma in the acute phase of intracerebral hemorrhage, but also they exists the effect of promotion, inhibition or regulation between the various inflammatory cytokines. However,at present there is no research on the comparative analysis of the correlation of the various inflammatory cytokines and tissue edema around hematoma and there is no confirmation of what kind of factor is a closer relationship to tissue edema around hematoma,and which factors is more representative in inflammatory reaction of the tissue edema arroud hematoma. This study determines IL-4,IL-6,IL-8,IL-10 levels of cerebral hematoma fluid and serum and explores the mechanism of brain edema,clears IL-4, IL-6,IL-8,IL-10 levels of cerebral hematoma fluid and serum and their relationship with brain edema,clears whether they are differences in serum and hematoma fluid from patients with the different amount of bleeding and hematoma fluid and compare correlation of IL-4, IL-6, IL-8,IL-10 in serum and hematoma fluid with brain edema,further understand correlation of inflammatory cytokines and brain edema and representative factor. It is guiding significance in clinical application of basic research cytokines,and provides a new theoretical basis for the development of drugs and surgical treatment of cerebral hemorrhage,guides clinical practice and saves the lives of patients.Method: 1. Selection standard: (1) A head CT confirmed that both basal ganglia hemorrhage has not broken into the ventricle to ensure that CT accuracy measurement of the amount of bleeding and the amount of edema (2)respiratory and circulatory function stable (3)intracerebral hemorrhage in a week2. Exclusion standard: (1) Over the past two weeks of infection or co-infection after admission; (2) recent surgery,trauma and a history of heart stroke; (3) vascular malformations,vasculitis,or intracerebral hemorrhage caused by coagulation disorder; (4) with severe heart,kidney,liver,and tumor diseases; (5) diabetes,hyperlipidemia; (6) recent seizures of TIA or stroke historyThe 89 case of patients with intracerebral hemorrhage were selected who were admitted to the Second Hospital of Hebei Medical University,Department of Neurology Hospital basal ganglia from February 2006 to January 2010. According to different time periods, they were divided into five groups (<6h,6~12h,12~24h,24~72h, 3~7d). Collecte intracranial hematoma fluid and venous blood of intracerebral hemorrhage patients. Continuous check 24h,72h,1w head CT of patients of less than 6h,and multi-Tian-type formula for the amount of bleeding and edema were calculated amount. IL-4,IL-6,IL-8,IL-10 in serum of 17 cases of healthy people as a comparative analysis. Collecte the morning fasting blood of 17 cases of healthy individuals. After serum was isolated from all specimens, and installed in a test tube installed the number and sealed, placed in -20 degrees refrigerator for inspection and storage, and avoid post-thaw. It was quantitative analysised ,using ELISA, with the kit for IL-4,IL-6,IL-8,IL-10. The experimental data was analysised with variance and correlation analysis and multiple linear regression analysis,all the measurement information and data were indicated with mean±standard deviation ( ).Results: The concentration of IL-4, IL-6, IL-8, IL-10 in the basal ganglia hemorrhage patients ,serum was significantly higher than in the normal control group and the difference was statistically significant (P<0.05); The concentration of IL-4, IL-6, IL-8, IL-10 in blood was no significant difference with in hematoma fluid, the difference is no statistically significant(P>0.05). The patients of basal ganglia hemorrhage in <6h, compared with the normal control group, the concentration of IL-4, IL-6, IL-8 in serum was significantly increased,the difference was statistically significant(P <0.05),while concentration of IL-10 was not significantly increased, the difference was not statistically significant (P>0.05); The concentration of IL-4, IL-6, IL-8 in the 24-72h reached the peak and started to decline in the 3-7d, but still higher than in the normal control group, The concentration of IL-4, IL-8 in the 24-72h period, compared with the other, their differences were significant (P<0.05), The concentration of IL-6 in the 24-72h was different from the <6h and the difference was statistically significant(P<0.05),but it was no significant differences from the other periods (P>0.05),while concentration of IL-10 continued to rise no peak, and it was were statistically different in the 3-7d from the other periods ,and the differences was statistically significant (P<0.5). The amount of bleeding in <6h~12-24h was gradually increasing, it reached the peak in the 12-24h,then gradually decreased, but the amount of bleeding each time was no significally different (P>0.05); The brain edema volume of the patients of basal ganglia hemorrhage in <6h didn,t appear, it was gradually increasing in the > 6h ~ 12-24h, and reached the peak in the 12-24h, then gradually decreased, but the amount of edema each time was no significant different(P>0.05);The edema volume of the patients of basal ganglia hemorrhage had a positive correlation with the amount of bleeding in 6h~7d, the correlate coefficient R= 0.693,(P <0.05),and it was statistically significant. IL-4,IL-6,IL-8,IL-10 each two were correlate and they had a positive correlation. IL-4 and IL-8 were significantly correlate and correlate coefficient R=0.937, (P<0.05),it was statistically significant. IL-4,IL-6,IL-8,IL-10 and the amount of bleeding were no obvious linear dependent, F=2.405,(P>0.05), so the fitting multiple linear regression equation is not statistically significant; IL - 4,IL-6,IL-8,IL-10 and the amount of the edema were linear dependent, multiple linear regression equation: Y = 7.651+0.108 X1+0.062 X2+0.004 X3-0.069X4, F= 3.601, (P>0.05), the fitting multiple linear regression equation is statistically significant, the absolute value of standardized regression coefficients of IL-4, IL-6,IL-8,IL-10 were 0.336,0.202,0.013,0.243. So their impact strength with cerebral edema was IL-4> IL-10> IL-6> IL-8.Conclusion: 1. The concentration of IL-4, IL-6, IL-8, IL-10 in the basal ganglia hemorrhage patients ,serum was significantly higher than in the normal control group;The concentration of IL-4, IL-6, IL-8, IL-10 in blood was no significant difference with in hematoma fluid. The patients of basal ganglia hemorrhage in <6h, compared with the normal control group, the concentration of IL-4, IL-6, IL-8 in serum was significantly increased,while concentration of IL-10 was not significantly increased; The concentration of IL-4, IL-6, IL-8 in the 24-72h reached the peak and started to decline in the 3-7d, but still higher than in the normal control group, while concentration of IL-10 continued to rise no peak. 2. The amount of bleeding in <6h~12-24h was gradually increasing, it reached the peak in the 12-24h,then gradually decreased; The brain edema volume of the patients of basal ganglia hemorrhage in <6h didn,t appear, it was gradually increasing in the > 6h ~ 12-24h, and reached the peak in the 12-24h, then gradually decreased;The edema volume of the patients of basal ganglia hemorrhage had a positive correlation with the amount of bleeding in 6h~7d. 3. IL-4,IL-6,IL-8,IL-10 each two were correlate and they had a positive correlation. IL-4 and IL-8 were significantly correlate. 4. IL-4,IL-6,IL-8,IL-10 and the amount of bleeding were no significally linear dependent, however, IL-4,IL-6,IL-8,IL-10 and the amount of edema were linear dependent, IL-4 had the greatest effect on cerebral edema. This experiment, by observing the changes of IL-4,IL-6,IL-8,IL-10 in the blood and hematoma fluid, and the correlation between the amount of bleeding and the amount of edema,analyzed whether IL-4,IL-6,IL-8, IL-10 and the amount of bleeding, the amount of edema volume existed a linear dependence,and by comparing their role and effect intensity on cerebral edema , both verified the relevant conclusions of scholars at home and abroad and made a new conclusion , provided a new theoretical basis for the clinical treatment of intracerebral hemorrhage and drug research.
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