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
GU Tianyan1,3, PAN Jingyu2, CHEN Lin3, ZOU Zhihao4, SHI Qinghai3()
Received:
2024-01-02
Accepted:
2024-06-03
Online:
2024-08-25
Published:
2024-08-25
Contact:
SHI Qinghai
E-mail:shiqinghai@aliyun.com
CLC Number:
GU Tianyan, PAN Jingyu, CHEN Lin, ZOU Zhihao, SHI Qinghai. The value of inflammatory cytokines(TNF-α, IL-6 and IL-8) in predicting prognosis in patients with new-onset intracerebral hemorrhage[J]. Journal of Diagnostics Concepts & Practice, 2024, 23(04): 405-415.
Table 1
Comparison of baseline information between study and control groups
Characteristic | ICH group (n=40) | Control group (n=40) | t/χ2 value | P value |
---|---|---|---|---|
Age (years) | 59.10±12.84 | 58.93±12.52 | 0.051 | 0.960 |
Sex [n (%)] | 0.054 | 0.816 | ||
Male | 26(65) | 25(62.5) | ||
Female | 14(35) | 15(37.5) | ||
Hypertensive [n (%)] | 18(45) | 13(32.5) | 1.317 | 0.251 |
Diabetes [n (%)] | 6(15) | 8(20) | 0.346 | 0.556 |
Cardiology [n (%)] | 3(7.5) | 5(12.5) | 0.556 | 0.456 |
BMI (kg/m2) | 23.49±4.16 | 22.22±3.42 | 1.550 | 0.125 |
Figure 1
Differences in the serum expression levels of TNF-α, IL-6 and IL-8 between the study and control groups The expression levels of (A) TNF-α (P<0.000 1); (B) IL-6 (P<0.000 1); and (C) IL-8 (P<0.000 1) were elevated in the study group. Note: All data are expressed as M (P25, P75), ****P<0.000 1. Abbreviations: CTL, control, n=40; ICH, intracerebral hemorrhage, n=40. The original result values have been transformed to their square root equivalents to facilitate a more distinct and three-dimensional portrayal of data distribution, denoted in sqrt pg/mL.
Figure 2
Differences in the expression levels of TNF-α, IL-6, and IL-8 in the cerebrospinal fluid between the study and control groups The expression levels of (A) TNF-α (P<0.000 1); (B) IL-6 (P<0.000 1); and (C) IL-8 (P<0.000 1) were elevated in the study group. Note: All data are expressed as M (P25, P75), ****P<0.000 1. Abbreviations: CTL, control, n=40; ICH, intracerebral hemorrhage, n=40. The original result values have been transformed to their square root equivalents to facilitate a more distinct and three-dimensional portrayal of data distribution, denoted in sqrt pg/mL.
Figure 3
Differences in serum TNF-α, IL-6 and IL-8 expression levels in intracerebral hemorrhage patients with different GCS scores (A) The serum levels of TNF-α in intracerebral hemorrhage patients with a GCS score of 3-8 were higher than those with a GCS score of 9-15 (P<0.01), (B) The serum levels of IL-6 in intracerebral hemorrhage patients with a GCS score of 3-8 were significantly higher than those with a GCS score of 9-15 (P<0.01), (C) The serum levels of IL-8 in intracerebral hemorrhage patients with a GCS score of 3-8 were significantly higher than those with a GCS score of 9-15 points (P<0.01). Note: All data are expressed as M (P25, P75), **: P < 0.01. GCS was 3 to 8 points, n=26; GCS was 9 to 15 points, n=14. The original result values have been transformed to their square root equivalents to facilitate a more distinct and three-dimensional portrayal of data distribution, denoted in sqrt pg/mL.
Figure 4
Differences in TNF-α, IL-6 and IL-8 expression levels in cerebrospinal fluid of intracerebral hemorrhage patients with different GCS (A) TNF-α levels in the cerebrospinal fluid of patients with intracerebral hemorrhage with GCS of 3-8 were higher than those with GCS of 9-15 (P<0.001), (B) IL-6 levels in the cerebrospinal fluid of patients with intracerebral hemorrhage with GCS of 3-8 were significantly higher than those with GCS of 9-15 (P<0.001), (C) IL-8 levels in the cerebrospinal fluid of patients with intracerebral hemorrhage with GCS of 3-8 were significantly higher than those with GCS of 9-15 points (P<0. 01). Note: All data are expressed as M (P25, P75), ***: P<0.001,**: P<0.01. GCS was 3 to 8 points, n=26; GCS was 9 to 15 points, n=14. The original result values have been transformed to their square root equivalents to facilitate a more distinct and three-dimensional portrayal of data distribution, denoted in sqrt pg/mL.
Figure 5
Expression levels of TNF-α, IL-6 and IL-8 in serum of patients with intracerebral hemorrhage of different blee-ding volume (A) The difference of serum TNF-α level was not statistically significant between the bleeding volume ≥30 mL group and the bleeding volume <30 mL group (P>0.05), (B) The serum IL-6 level of patients in the bleeding volume ≥30 mL group was higher than that of the bleeding volume <30 mL group (P<0.05), and (C) The serum IL-8 level of the patients in the bleeding volume ≥30 mL group and the bleeding volume <30 mL group The difference was not statistically significant (P>0.05). Note: All data are expressed as M (P25, P75), *: P<0.05, ns P>0.05. The bleeding volume ≥30 mL group, n=21; the bleeding volume <30 mL group, n=19. The original result values have been transformed to their square root equivalents to facilitate a more distinct and three-dimensional portrayal of data distribution, denoted in sqrt pg/mL.
Figure 6
Expression levels of TNF-α, IL-6 and IL-8 in the cerebrospinal fluid of patients with intracerebral hemorrhage of different bleeding volumes (A) TNF-α level in cerebrospinal fluid of patients in the bleeding volume ≥30 mL group was higher than that in the bleeding volume <30 mL group (P<0.05), (B) IL-6 level in cerebrospinal fluid of patients in the bleeding volume ≥30 mL group was higher than that in the bleeding volume <30 mL group (P<0.001), (C) IL-8 level in cerebrospinal fluid of patients in the bleeding volume ≥30 mL group was higher than that in the bleeding volume <30 mL group (P< 0.05). Note: All data are expressed as M (P25, P75), ***: P<0.001,*: P<0.05. The bleeding volume ≥30mL group, n=21; the bleeding volume <30 mL group, n=19. The original result values have been transformed to their square root equivalents to facilitate a more distinct and three-dimensional portrayal of data distribution, denoted in sqrt pg/mL.
Table 2
Comparison of indicators in the good prognosis group and the poor prognosis group
Characteristic | Favorable(n=18) | Unfavorable(n=22) | t/χ2/Z value | P value |
---|---|---|---|---|
Age (years) | 56.39±14.37 | 61.91±12.04 | 1.323 | 0.194 |
Sex [n (%)] | 0.559 | 0.455 | ||
Male | 12 (66.7) | 17 (77.3) | ||
Female | 6 (33.3) | 5 (22.7) | ||
Hypertensive [n (%)] | 5 (27.8) | 13 (59.1) | 3.922 | <0.05 |
Diabetes [n (%)] | 2 (11.1) | 4 (18.2) | 0.388 | 0.533 |
Cardiology [n (%)] | 2 (7.1) | 1 (12.5) | 0.615 | 0.433 |
Hematoma location [n (%)] | 1.397 | 0.806 | ||
Basal ganglia | 8 (44.4) | 11 (50) | ||
Thalamus | 3 (16.7) | 5 (22.7) | ||
Lobar | 4 (22.2) | 2 (9.1) | ||
Other | 3 (16.7) | 4 (18.2) | ||
GCS (points) | 10.56±3.49 | 5.68±2.06 | -5.502 | <0.000 1 |
ICH volume(mL) [n (%)] | 4.821 | <0.05 | ||
≥30 mL | 6 (33.3) | 15 (68.2) | ||
<30 mL | 12 (66.7) | 7 (31.8) | ||
Blood sugar (mmol/L) | 6.57 (5.58, 7.13) | 10.16 (7.78, 12.90) | -3.833 | <0.000 1 |
Albumin (g/L) | 39.28±3.77 | 36.96±4.03 | -1.866 | 0.070 |
Calcitonin (ng/mL) | 0.27 (0.06, 0.57) | 0.10 (0.26, 0.73) | -0.802 | 0.422 |
WBC (109/L) | 9.92 (7.61, 12.43) | 10.68 (9.01, 12.70) | -0.802 | 0.423 |
D-dimer (mg/L) | 1.47 (0.36, 2.55) | 1.88 (1.08, 6.03) | -1.495 | 0.135 |
Figure 7
Differences in serum TNF-α, IL-6 and IL-8 expression levels in patients with intracerebral hemorrhage with different GOS (A) The serum levels of TNF-α were significantly higher in patients with a GOS of 1-3 than in patients with a GOS of 4-5 (P<0.01), (B) The serum levels of IL-6 were significantly higher in patients with a GOS of 1-3 than in patients with a GOS of 4-5 (P<0.001), and (C) The serum levels of IL-8 were significantly higher in patients with a GOS of 1-3 than in patients with a GOS of 4-5 (P<0.001). Note: All data are expressed as M (P25, P75), ***: P<0.001,**: P<0.01. GOS was 1-3 points, n=22; GOS was 4-5 points, n=18. The original result values have been transformed to their square root equivalents to facilitate a more distinct and three-dimensional portrayal of data distribution, denoted in sqrt pg/mL.
Figure 8
Differences in the expression levels of TNF-α, IL-6 and IL-8 in the cerebrospinal fluid of patients with intracerebral hemorrhage with different GOS (A) TNF-α levels in the cerebrospinal fluid of patients with GOS of 1-3 were significantly higher than those with GOS of 4-5 (P<0.001), (B) IL-6 levels in the cerebrospinal fluid of patients with GOS of 1-3 were significantly higher than those with GOS of 4-5 (P<0.01), and (C) IL-8 levels in the cerebrospinal fluid of patients with GOS of 1-3 were significantly higher than those with GOS of 4-5 (P< 0.001). Note: All data are expressed as M (P25, P75), ***: P<0.001,**: P<0.01. GOS was 1-3 points, n=22; GOS was 4-5 points, n=18. The original result values have been transformed to their square root equivalents to facilitate a more distinct and three-dimensional portrayal of data distribution, denoted in sqrt pg/mL.
Table 3
Analysis of factors influencing the functional prognosis of patients with intracerebral hemorrhage
Cytokines | β value | SE | Wald value | OR (95%CI) | P value |
---|---|---|---|---|---|
TNF-α in CSF | 0.166 | 0.068 | 6.009 | 1.181 (1.034, 1.349) | 0.014 |
TNF-α in serum | 0.013 | 0.005 | 6.060 | 1.013 (1.003, 1.023) | 0.014 |
IL-6 in CSF | 1.702 | 0.845 | 4.054 | 1.000 (1.000, 1.001) | 0.044 |
IL-6 in serum | 0.093 | 0.034 | 7.230 | 1.097 (1.025, 1.174) | 0.007 |
IL-8 in CSF | 0.001 | 0.000 | 6.888 | 1.001 (1.000, 1.002) | 0.009 |
IL-8 in serum | 0.023 | 0.008 | 7.773 | 1.023 (1.007, 1.040) | 0.005 |
GCS | -0.600 | 0.187 | 10.330 | 0.549 (0.381, 0.791) | 0.001 |
ICH volume | 1.455 | 0.678 | 4.609 | 4.286 (1.135, 16.18) | 0.032 |
Table 4
Analysis of the prognostic predictive value of serum TNF-α, IL-6, IL-8 levels and the combination for intracerebral hemorrhage
Cytokines | AUC | Sensitivity (%) | Specificity (%) | 95%CI | Youden index | Cutoff value (pg/mL) | P value |
---|---|---|---|---|---|---|---|
TNF-α | 0.692 | 86.4 | 55.6 | 0.524-0.860 | 0.42 | 73.69 | 0.038 8 |
IL-6 | 0.808 | 77.3 | 88.9 | 0.662-0.953 | 0.662 | 12.79 | 0.000 9 |
IL-8 | 0.721 | 90.9 | 50.0 | 0.559-0.883 | 0.409 | 13.09 | 0.017 4 |
Combine | 0.843 | 81.8 | 77.8 | 0.720-0.967 | 0.596 | — | 0.000 2 |
Table 5
Analysis of the prognostic predictive value of cerebrospinal fluid TNF-α, IL-6, IL-8 levels and combination for intracerebral hemorrhage
Cytokines | AUC | Sensitivity (%) | Specificity (%) | 95%CI | Youden index | Cutoff value (pg/mL) | P value |
---|---|---|---|---|---|---|---|
TNF-α | 0.836 | 63.6 | 100 | 0.711-0.961 | 0.636 | 15.60 | 0.000 3 |
IL-6 | 0.773 | 54.5 | 94.4 | 0.628-0.918 | 0.489 | 3 281.96 | 0.003 3 |
IL-8 | 0.849 | 68.2 | 94.4 | 0.732-0.965 | 0.626 | 1 982.95 | 0.000 2 |
Combine | 0.917 | 72.7 | 100 | 0.835-0.999 | 0.727 | — | 0.000 1 |
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