血管损伤的分子标记与脑内出血的早期蔓延有关  

Molecular signatures of vascular injury are associated with early growth of intracerebral hemorrhage

作　　者：Silva Y. Leira R. Tejada J. A. D' avalos 沈才飞 

机构地区：[1]Department of Neurology, Hosp. Univ. Doctor Josep Trueta, E- 17007 Girona, Spain Dr.

出　　处：《世界核心医学期刊文摘（神经病学分册）》2005年第6期56-56,共1页Digest of the World Core Medical Journals:Clinical Neurology

摘　　要：Background and Purpose - To investigate whether molecular markers of inflammation and endothelial injury are associated with early growth of intracerebral hemorrhage (ICH). Methods - In a multicenter prospective study, we determined concentrations of interleukin- 6 (IL- 6), tumor necrosis factor- α (TNF- α ), matrix metalloproteinase- 9 (MMP- 9), and cellular fibronectin (c- Fn) in blood samples obtained on admission from 183 patients with primary hemispheric ICH of < 12 hours’ duration. Patients had a neurological evaluation and a computed tomography (CT) scan performed at baseline and at 48± 6 hours. Early growth of the ICH was defined as a volume increase >33% between the 2 CT examinations for ICH with a baseline volume < 20 mL and >10% for ICH ≥ 20 mL. Clinical, radiological, and biochemical predictive factors of ICH enlargement were analyzed by logistic regression analysis. Results - Fiftyfour (29.5% ) patients showed a relevant early growth of ICH. High leukocyte count and fibrinogen levels, low platelet count, and intraventricular bleeding were associated with early ICH growth in bivariate analyses. Plasma concentrations of IL- 6 (median [quartiles]: 19.6 [13.6; 29.9] versus 15.9 [11.5; 19.8]pg/mL), TNF- α (13.5 [8.4; 30.5] versus 8.7 [4.7; 13.5] pg/mL), MMP- 9 (153.3 [117.7; 204.7] versus 70.6 [47.8; 103.8] ng/mL), and c- Fn (8.8 [6.2; 12.5] versus 2.8 [1.6; 4.2] μ g/mL) were significantly higher in patients with early growth of ICH (all P< 0.001). C- Fnlevels >6 μ g/mL (OR, 92; 95% CI, 22 to 381; P< 0.0001) and IL- 6>24 pg/mL (OR, 16; 95% CI, 2.3 to 119; P=0.005) were independently associated with ICH enlargement in the logistic regression analysis. Conclusions - Molecular signatures of vascular injury and inflammatory markers in the early acute phase of ICH are associated with subsequent enlargement of the hematoma.Background and Purpose - To investigate whether molecular markers of inflammation and endothelial injury are associated with early growth of intracerebral hemorrhage (ICH). Methods - In a multicenter prospective study, we determined concentrations of interleukin- 6 (IL- 6), tumor necrosis factor- α (TNF- α ), matrix metalloproteinase- 9 (MMP- 9), and cellular fibronectin (c- Fn) in blood samples obtained on admission from 183 patients with primary hemispheric ICH of < 12 hours’ duration. Patients had a neurological evaluation and a computed tomography (CT) scan performed at baseline and at 48± 6 hours. Early growth of the ICH was defined as a volume increase >33% between the 2 CT examinations for ICH with a baseline volume < 20 mL and >10% for ICH ≥ 20 mL. Clinical, radiological, and biochemical predictive factors of ICH enlargement were analyzed by logistic regression analysis. Results - Fiftyfour (29.5% ) patients showed a relevant early growth of ICH. High leukocyte count and fibrinogen levels, low platelet count, and intraventricular bleeding were associated with early ICH growth in bivariate analyses. Plasma concentrations of IL- 6 (median [quartiles]: 19.6 [13.6; 29.9] versus 15.9 [11.5; 19.8]pg/mL), TNF- α (13.5 [8.4; 30.5] versus 8.7 [4.7; 13.5] pg/mL), MMP- 9 (153.3 [117.7; 204.7] versus 70.6 [47.8; 103.8] ng/mL), and c- Fn (8.8 [6.2; 12.5] versus 2.8 [1.6; 4.2] μ g/mL) were significantly higher in patients with early growth of ICH (all P< 0.001). C- Fnlevels >6 μ g/mL (OR, 92; 95% CI, 22 to 381; P< 0.0001) and IL- 6>24 pg/mL (OR, 16; 95% CI, 2.3 to 119; P=0.005) were independently associated with ICH enlargement in the logistic regression analysis. Conclusions - Molecular signatures of vascular injury and inflammatory markers in the early acute phase of ICH are associated with subsequent enlargement of the hematoma.

关 键 词：脑内出血 血管损伤 病灶体积 神经学 脑室内出血 纤维结合素 肿瘤坏死因子α 血液样本 基质金属蛋白酶 双变量分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]