Journal of Diagnostics Concepts & Practice ›› 2024, Vol. 23 ›› Issue (04): 405-415.doi: 10.16150/j.1671-2870.2024.04.009

• Original articles • Previous Articles     Next Articles

The value of inflammatory cytokines(TNF-α, IL-6 and IL-8) in predicting prognosis in patients with new-onset intracerebral hemorrhage

GU Tianyan1,3, PAN Jingyu2, CHEN Lin3, ZOU Zhihao4, SHI Qinghai3()   

  1. 1. Graduate School of Xinjiang Medical University, Urumqi 830011, China
    2. Clinical Laboratory Diagnostics, School of Medicine, Shihezi University, Shihezi 832000, China
    3. Clinical Laboratory Diagnostic Center, General Hospital of Xinjiang Military Command, Urumqi 830000, China
    4. Department of Neurosurgery, General Hospital of Xinjiang Military Command, Urumqi 830000, China
  • Received:2024-01-02 Accepted:2024-06-03 Online:2024-08-25 Published:2024-08-25
  • Contact: SHI Qinghai E-mail:shiqinghai@aliyun.com

Abstract:

Objective To investigate correlation of levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and IL-8 in cerebrospinal fluid with the severity of the disease in patients with intracerebral hemorrhage, and to analyze the value of the cytokines for predicting prognosis of the patients. Methods A total of 40 patients with new-onset intracerebral hemorrhage, admitted to the Department of Neurosurgery of the General Hospital of Xinjiang Military Region, were collected from March 2023 to December 2023. Forty patients who underwent cerebrospinal fluid examination at the hospital due to the presence of clinical symptoms, but whose central nervous system disease was eventually excluded, served as the control group. Within 24 h of the onset of illness, the patient's cerebrospinal fluid was collected,as well as the laboratory test results. The levels of inflammatory cytokines TNF-α, IL-6, and IL-8 were measured both in serum and cerebrospinal fluid samples. Patients were divided into the mild-moderate group (GCS 9-15, n=14) and severe group (GCS 3-8, n=26) accor-ding to the Glasgow coma scale (GCS) on admission, and also were divided into ≥30mL group (n=21) and <30mL group (n=19) according to the hemorrhage volume. At 90 days after discharge, the patients with intracerebral hemorrhage were divided into a good prognosis group (GOS 4-5 points, n=18) and a poor prognosis group (GOS 1-3 points, n=22) according to the Glasgow out-come scale (GOS). Spearman correlation coefficient and Receiver operating characteristic curve (ROC) was used to analyze the value of inflammatory cytokines in serum and cerebrospinal fluid for predicting the prognosis in patients with intracerebral hemorrhage. Results Compared with the control group, TNF-α, IL-6 and IL-8 levels in serum and cerebrospinal fluid were significantly increased in the intracerebral hemorrhage (P<0.001). The levels of TNF-α, IL-6 and IL-8 in serum and cerebrospinal fluid were higher in the severe intracerebral hemorrhage group than those in the mild-moderate group (P<0.01), and all of them were negatively correlated with the GCS score (r=-0.397, P<0.05; r=-0.587, P<0.01; r=-0.615, P<0.01; r=-0.696, P<0.01; r=-0.671, P<0.01; r=-0.510, P<0.01). Compared with patients in the group of hemorrhage volume <30mL, TNF-α, IL-6 and IL-8 levels in cerebrospinal fluid of patients in the ≥30 mL group were elevated (P<0.05), and in serum only IL-6 levels were elevated (P<0.05). The levels of TNF-α, IL-6 and IL-8 in serum and cerebrospinal fluid were elevated in the poor prognosis group compared with the good prognosis group (P<0.01). The area under the curve (AUC) of single and combined detection of TNF-α, IL-6 and IL-8 in the cerebrospinal fluid of patients with cerebral hemorrhage for the first time on admission to the hospital for predicting the prognosis of patients with cerebral hemorrhage were 0.836, 0.773, 0.849, and 0.917, respectively. The AUC of single and combined tests of serum TNF-α, IL-6 and IL-8 in patients within 24 h admission for predicting the prognosis were 0.692, 0.808, 0.721 and 0.843, respectively. Conclusions TNF-α, IL-6 and IL-8 levels are elevated in the cerebrospinal fluid of patients with intracerebral hemorrhage, and they correlated with the severity of the patient's condition. In addition, the levels of these indicators in the cerebrospinal fluid detected for the first time on admission may be used to predict the prognosis 90 days after discharge.

Key words: Intracerebral hemorrhage, Cerebrospinal fluid, Serum, Inflammation, Cytokines

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