急性脑出血患者血管内皮生长因子和肿瘤坏死因子-α的动态变化研究  

Change of serum VEGF and TNF-α in the patients with intracerebral hemorrhage

作　　者：史福平[1] 张国华[2] 王敬文[1] 苏立凯[1] 林杰 李会敏[1] 李晓芳[1] 王珊[4] 高瑞利[2] 

机构地区：[1]河北大学附属医院神经内科,河北保定071000 [2]河北医科大学第二医院神经内科 [3]邯郸市人民医院神经内科 [4]北京宣武医院神经内科

出　　处：《中国急救医学》2007年第2期109-112,共4页Chinese Journal of Critical Care Medicine

基　　金：河北省自然科学基金资助项目(No.C2005000748);河北省卫生厅医学科学研究重点课题计划资助项目(No.04049)

摘　　要：目的探讨血管内皮生长因子(VEGF)和肿瘤坏死因子-α(TNF-α)在急性脑出血患者中的动态变化及意义。方法分别采用双抗体夹心ELISA法和平衡放射免疫法测定32例急性脑出血患者发病24h内、7d、14d时和30名健康对照者的血清VEGF和TNF-α水平,并对其进行相关性分析。结果①脑出血组血清VEGF和TNF-α明显高于正常对照组(P<0.05),脑出血发生后24h内血清VEGF和TNF-α即开始升高,在7d时达高峰,14d时仍维持较高水平。②脑出血组血清VEGF和TNF-α水平与血肿量大小及病情轻重有关血肿量越大,血清VEGF和TNF-α水平越高,但是血清TNF-α水平与血肿量的大小有相关性(P<0.05),血清VEGF水平与血肿量的大小无相关性(P>0.05)。③血肿周围水肿体积的大小与血清VEGF和TNF-α水平有相关性(r=0.400,P<0.05;r=0.828,P<0.001)。结论血清VEGF和TNF-α在脑出血发生后呈动态变化,并与血肿周围水肿体积大小相关,提示VEGF和TNF-α参与了急性脑出血后的病理过程。Objective To study the dynamic changes of vascular endothelial growth factor （VEGF） and tumor necrosis factor （TNF）-α and their clinical significance in the patients with acute intracerebral hemorrhage. Methods Serum VEGF levels were determined by ELISA and serum TNF -α levels were determined by radioimmunization in 32 patients with acute intracerehral hemorrhage and 30 healthy controls within 24 h, at 7 and 14 d after the onset of acute intracerebral hemorrhage, and the correlation between VEGF and TNF -α was studied. Results The levels of VEGF and TNF -α in the patients with acute intracerebral hemorrhage were much higher than those in control group （ P 〈 0.05 ）, the levels of serum VEGF and TNF -α gradually increased after the onset of acute intracerebral hemorrhage and reached the peak at 7 d, and didn＇t return to normal level at 14 d. The cerebral hemon＇hage patients with larger hematoma volume had higher VEGF and TNF -α levels. VEGF was not related to hematoma volume（ P 〉0.05 ）, but serum TNF -α level correlated with hematoma volume（ P 〈0.05 ）. Perihaematomal edema volumes correlated with VEGF and TNF -α （ r =0. 400, P 〈0. 05 ; r =0. 828, P 〈0.001 ）. Conclusions The dynamic changes of VEGF and TNF -α contents after intracerebral hemorrhage indicated that VEGF and TNF -α may take part in the pathological process after acute intracerebral hemorrhage, and correlated with pefihaematomal edema volumes. There is clinical significance to make further study.

关 键 词：脑出血 血管内皮生长因子 肿瘤坏死因子-Α 脑水肿 

分 类 号：R743.3[医药卫生—神经病学与精神病学]