Clinical study of systemic inflammatory response syndiome induced MODS in acute cerebral infarction

Objective To explore the mechanism of the acute cerebral infarction leading to systemic inflammatory response syndrome (SIRS) which causes multiple organ dysfunction syndrome (MODS), and to explore the role of tumor necrosis factor (TNF-α) and IL-1β in the mechanism from SIRS to MODS.Methods 68 cases of acute cerebral infarction (ACI) were divided into three groups. They were 36 cases of simple acute cerebral infarction (SACI group), 32 cases accompanied with SIRS (SIRS group) and 24 cases accompanied with MODS (MODS group). Enzyme linked immunosorbent assay (ELISA) method was used to measure serum TNF-α and IL-1β contents at different time after ACI and compared with 28 healthy persons.Results (1) 47.06% of the 68 cases were accompanied with SIRS, of whom 75.00% were accompanied with MODS.(2) The serum TNF-α and IL-1β levels were the highest in MODS group, next in SIRS group, then in SACI group, the lowest in control group. The differences were significant among 4 groups (all P0.01). The serum TNF-α and IL-1β levels in severe cases with MODS (score more than 9) were higher than those in mild cases (score less than 9) (all P0.01). Furthermore, the serum TNF-α and IL-1β levels were higher in the patients died of MODS than in the patients with MODS but survival (all P0.01).Conclusions Acute cerebral infarction may progress with SIRS and then lead to MODS. The changes of serum TNF-αand IL-1β contents are the possible indexes in judging the patients with ACI whether or not lead to SIRS and MODS.