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血清和脑脊液中白细胞介素-4 水平升高与动脉瘤性蛛网膜下腔出血不良预后相关。

Elevated serum and cerebrospinal fluid levels of Interleukin-4 related to poor outcome of Aneurysmal subarachnoid hemorrhage.

机构信息

Clinical Medical College of Jining Medical University, Jining 272067, China; Department of Emergency, Jining No. 1 People's Hospital, Jining 272011, China.

Department of Emergency, Zouping People's Hospital, Binzhou 256200, China.

出版信息

Cytokine. 2024 Dec;184:156780. doi: 10.1016/j.cyto.2024.156780. Epub 2024 Oct 20.

Abstract

Aneurysmal subarachnoid hemorrhage (aSAH) is a hemorrhagic cerebrovascular disease that seriously jeopardizes human life and health. Some studies have shown that although Interleukin-4 (IL-4) acts as an anti-inflammatory factor, IL-4 levels are elevated when the disease occurs. This study focuses on exploring the relationship between IL and 4 concentrations in the serum and cerebrospinal fluid (CSF) and poor outcome in patients with aSAH. This study was a prospective observational study and 210 aSAH patients who met the inclusion criteria were divided into two groups according to the mRS score at 3 months after discharge, and 210 healthy people were selected as controls. The IL-4 concentrations were quantitatively determined with enzyme-linked adsorption assay (ELISA). We can draw a conclusion that Serum and CSF IL-4 concentrations are generally elevated in patients with poor outcome(P < 0.05), and the CSF IL-4 concentration decreased gradually over the progress of time (P < 0.05). The IL-4 concentration in the CSF was positively correlated with age, platelet-lymphocyte ratio (PLR), C-reactive protein (CRP), Hunt-Hess grade, mRS score, and World Federation of Neurological Surgeons score (WFNS) (P < 0.0001). Additionally, IL-4 concentrations in the CSF were correlated with complications such as intracranial infection (P = 0.01), cerebral edema (P < 0.01), hydrocephalus (P = 0.02), and complications by DCI (P = 0.02). Elevated serum and CSF concentrations of IL-4 may associated with the outcome of aSAH and may be a candidate early biomarkers for outcome of aSAH.

摘要

颅内动脉瘤性蛛网膜下腔出血(aSAH)是一种严重危及人类生命和健康的出血性脑血管病。一些研究表明,虽然白细胞介素-4(IL-4)作为一种抗炎因子,但在疾病发生时其水平升高。本研究旨在探讨血清和脑脊液(CSF)中 IL 与 4 浓度与 aSAH 患者不良预后的关系。本研究为前瞻性观察性研究,根据出院后 3 个月 mRS 评分将 210 例符合纳入标准的 aSAH 患者分为两组,并选择 210 名健康人作为对照。采用酶联吸附试验(ELISA)定量测定 IL-4 浓度。我们可以得出结论,预后不良患者的血清和 CSF IL-4 浓度普遍升高(P<0.05),且 CSF IL-4 浓度随时间推移逐渐降低(P<0.05)。CSF 中的 IL-4 浓度与年龄、血小板淋巴细胞比值(PLR)、C-反应蛋白(CRP)、Hunt-Hess 分级、mRS 评分和世界神经外科联合会评分(WFNS)(P<0.0001)呈正相关。此外,CSF 中的 IL-4 浓度与颅内感染(P=0.01)、脑水肿(P<0.01)、脑积水(P=0.02)和 DCI 并发症(P=0.02)等并发症相关。升高的血清和 CSF 中 IL-4 浓度可能与 aSAH 的预后相关,可能是 aSAH 预后的候选早期生物标志物。

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