β-七叶皂甙钠对脑出血患者血清肿瘤坏死因子-α含量变化的影响  

Change of tumor necrosis factor alpha content in blood of patients with intracerebral hemorrhage and therapeutic effect of sodium aescinate

作　　者：史福平[1] 张国华[1] 王珊[1] 张林静[1] 尹晶[1] 张晓炜[1] 王惠凌[1] 

机构地区：[1]河北医科大学第二医院神经内科,河北石家庄050000

出　　处：《临床荟萃》2006年第6期390-392,共3页Clinical Focus

基　　金：河北省自然科学基金资助项目(C2005000748)

摘　　要：目的观察脑出血患者发病后两周内血清肿瘤坏死因子-α(TNF-α)含量变化规律及β-七叶皂甙钠对其变化的影响。方法将高血压基底节区脑出血患者60例,随机分为治疗组[在常规治疗基础上加用β-七叶皂甙钠(商品名:叶欣钠)注射液]和常规组,两组各30例;另外选择健康者20例为对照组;放射免疫法测定发病后24小时、7天、14天血清TNF-α含量。结果常规组患者血清TNF-α在发病后24小时升高,7天时达高峰,14天时又下降,但仍高于对照组(P<0.001);同病程治疗组与常规组比较,TNF-α含量有不同程度下降,在7天和14天时最明显(P<0.01);急性期TNF-α含量与出血量的大小及血肿周围水肿体积呈正相关(P<0.01)。结论TNF-α参与了脑出血的病理生理过程,出血量和水肿越大,其含量越高,可作为神经元损伤的定量生化标记物,并可作为监测病情变化和药物疗效评价的指标。叶欣钠通过调节脑出血患者血清TNF-α水平来保护神经元,改善预后。Objective To observe the dynamic changes of tumor necrosis factor alpha （TNF-α） in blood of patients with intracerebral hamorrhage （ICH） in two weeks after onset,and to evaluate the therapeutic effect of sodium aescinate on its changes. Methods Sixty cases with hypertensive ICH of basal ganglion were randomly divided into sodium aescinate treated group （sodium aescinate used with general treatment） and general treatment group, while normal control group was set up by 20 heathy persons. TNF-α content in blood was measured by radio-immunoassay method at different time after ICH onset （the first 24 hours, 7th day, 14th day）. Results TNF-α in general treatment group was significantly higher than that in control group （ P 〈0. 001） ,and TNFa increased within the first 24 hours after ICH onset, reached climax at 7th day, and decreased obviously at 14th day; its content was positively related to the volume of hemorrhage and edema, there was obvious decrease of its content in sodium aeseinate treated group when compared with general treatment group, but higher than that in control group （ P 〈 0.01）. Conclusion TNF-α participates in the pathophysiological process of brain damage after ICH, the larger the volume of hemorrhage and edema the higher the content of TNF-α in blood. Therefore, TNF-α may serve as a quantitative biochemical marker of neuron damage when stroke occurs, the index of monitoring state of patients with stroke and the index of evaluateing curative effect of drug; in patients of ICH, sodium aeseinate may have neuroproteetive action and improve prognosis which depend on decreasing the synthesis and/or release of TNF-α.

关 键 词：脑出血 Β-七叶皂甙钠 肿瘤坏死因子-Α 

分 类 号：R743.34[医药卫生—神经病学与精神病学]