急性脑梗死后患者血清肿瘤坏死因子α与MRI动态变化的相关性研究  

Study on the correlation between serum TNF-α level and dynamic MRI performance in the patients with acute cerebral infarction

作　　者：李晓宾[1] 平蕾[1] 李传玲[1] 鹿寒冰[1] 崔晓[1] 郭靖[1] 安晓雷[1] 李洪远[1] 

机构地区：[1]江苏省徐州市中心医院神经内科,221009

出　　处：《中华脑科疾病与康复杂志（电子版）》2013年第4期12-15,共4页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

基　　金：徐州市科技计划项目(XZZD1123)

摘　　要：目的通过研究急性脑梗死后患者血清肿瘤坏死因子α(TNF-α)与MRI各项指标动态变化,探讨血清TNF-α在急性脑梗死后脑水肿形成中的作用。方法测定30例急性脑梗死患者在发病后1、5及14 d的血清TNF-α,另外在相应时间点行MRI扫描,处理合成表观弥散系数(ADC)图,测量计算脑梗死体积、各序列的信号强度比(SIR)、信号强度比相对变化率(ΔSIR)、相对表观弥散系数(rADC)。另取同一时期的30例健康体检者作为正常对照组,在清晨测定血清TNF-α。结果急性脑梗死患者在脑梗死后1 d,血清TNF-α即明显高于正常组对照组,在5 d时显著增高,14 d时明显降低,但仍高于对照组,各时间点间比较差异有统计学意义(F=51.106,P=0.000),血清TNF-α与脑梗死体积、T2WI及FLAIR的SIR均呈线型正相关(r=0.761、0.880、0.926,均P=0.000)。血清TNF-α与T1WI的SIR呈线型负相关(r=-0.796,P=0.000),在梗死后1 d、5 d的血清TNF-α与DWI序列的SIR呈线型正相关(r=0.926,P=0.000),脑梗死后1 d的血清TNF-α与rADC呈线型负相关(r=-0.910,P=0.000)。结论血清TNF-α的增高与缺血性脑水肿的形成、发展密切相关。Objective By studying dynamic changes of serum TNF-α and MRI indicators in order to explore the effect of serum TNF-α in the formation of cerebral edema after acute cerebral infarction. Methods The serum TNF-α was measured in thirty patients at 1 d, 5 d and 14 d after acute cerebral infarction. MRI scans and apparent diffusion coefficient （ADC） graph processing and synthesis were performed in the corresponding time. Cerebral infarction volume, signal intensity ratio （ SIR ） of each sequence ,signal intensity ratio relative change rate（ASIR） and relative apparent diffusion coefficient（rADC） were measured and calculated. Thirty healthy persons during the same period were chosen as the normal control group and their serum TNF-α were measured in the morning. Results The serum TNF-α in patients with acute cerebral infarction were significantly higher than that in normal control group at 1 d after cerebral infarction, and increased significantly at 5 d, decreased significantly at 14 d, but still higher than that of the control group. Compared with each time point, the difference had statistical significance （F = 51. 106, P = 0. 000）. There were liner positive correlation between the serum TNF-ot and the volume of cerebral infarction,SIR of T2WI and FLAIR（r =0. 761,0. 880,0. 926,all P =0. 000）. The serum of TNF-ot and SIR T1WI showed a linear negative correlation（r = -0. 796,P =0. 000）. The serum of TNF-ct and SIR of DWI sequence at 1 d, 5 d after cerebral infarction showed a linear positive correlation （ r = 0. 926, P = 0. 000）. There were liner negative correlation between the serum TNF-α and rADC at 1 d after cerebral infarction（ r = - 0. 910, P = 0. 000）. Conclusion The rise of serum TNF-α is closely related to the formation and development of ischemic brain edema.

关 键 词：肿瘤坏死因子Α 脑梗死 脑水肿 磁共振成像 

分 类 号：R743.33[医药卫生—神经病学与精神病学]