血清肿瘤坏死因子-α、神经生长因子与急性脑出血后脑水肿程度及预后的关系  

Relationship of serum level of TNF-αand NGF with degree of brain edema and prognosis after acute cerebral hemorrhage

作　　者：苑建鑫 李萃萃 修波[2] Jian-xin Yuan;Cui-Cui Li;Bo Xiu(Emergency Surgery,Tianjin TEDA Hospital,Tianjin,300347,China;Department of Neurosurgery,The 7th Medical Center of PLA General Hospital Beijing,100700,China)

机构地区：[1]天津市泰达医院急诊外科,天津300347 [2]解放军总医院第七医学中心神经外科,北京100700

出　　处：《中国现代医学杂志》2020年第19期29-33,共5页China Journal of Modern Medicine

摘　　要：目的探讨血清肿瘤坏死因子-α(TNF-α)、神经生长因子(NGF)与急性脑出血后脑水肿程度及预后的关系。方法选取2014年1月—2018年6月解放军总医院第七医学中心收治的急性脑出血患者200例为研究对象,根据脑水肿体积将患者分为轻度水肿组(68例)、中度水肿组(70例)及重度水肿组(62例),检测并比较3组患者不同时间点血清TNF-α、NGF质量浓度。根据预后情况将患者分为存活组(172例)和死亡组(28例)。采用Pearson法分析血清TNF-α、NGF与患者脑水肿严重程度的相关性,用Logistic回归模型分析患者预后的影响因素。结果3组不同时间点的TNF-α和NGF质量浓度有差异(P<0.05);3组的TNF-α和NGF质量浓度有差异(P<0.05),随着脑水肿严重程度的升高患者血清TNF-α和NGF质量浓度升高;3组的TNF-α和NGF质量浓度变化趋势有差异(P<0.05)。存活组TNF-α、NGF质量浓度均低于死亡组(P<0.05)。TNF-α(r=0.462,P<0.05)、NGF(r=0.491,P<0.05)与急性脑出血后脑水肿严重程度呈正相关。脑水肿严重程度(O^R=1.091,95%CI:1.020,1.275)、TNF-α(O^R=1.059,95%CI:1.011,1.176)、NGF(O^R=0.972,95%CI:0.778,0.998)是急性脑出血患者死亡的危险因素。结论急性脑出血患者脑水肿严重程度与血清TNF-α、NGF相关,检测上述指标可评估急性脑出血后脑水肿病情严重程度。Objective To investigate the relationship of serum level of tumor necrosis factor-α(TNF-α)and nerve growth factor(NGF)with the degree of brain edema and prognosis after acute cerebral hemorrhage.Methods A total of 200 patients with acute cerebral hemorrhage admitted in the Seventh Medical Center of PLA General Hospital from January 2014 to June 2018 were retrospectively selected as the study subjects.The patients were divided into mild edema group(n=68),moderate edema group(n=70)and severe edema group(n=62)according to the volume of brain edema.The serum level of TNF-αand NGF was detected and compared at different time points in the three groups.According to the prognosis,patients were divided into survival group(n=172)and death group(n=8).Pearson correlation was used to analyze the correlation between serum TNF-α,NGF level and the severity of brain edema,and the influencing factor of prognosis was analyzed by Logistic regression models.Results Compared with the contents of TNF-αand NGF at different time points,the contents of TNF-αand NGF at different time points in the three groups were different(P<0.05);the contents of TNF-αand NGF in the three groups were different(P<0.05),and the contents of serum TNF-αand NGF increased with the increase of the severity of brain edema;the change trend of TNF-αand NGF contents in three groups was different(P<0.05).The levels of TNF-αand NGF in survival group were lower than those in death group(P<0.05).The levels of TNF-α(r=0.462,P<0.05)and NGF(r=0.491,P<0.05)were positively correlated with the severity of cerebral edema after acute cerebral hemorrhage.The severity of cerebral edema[O^R=1.091(95%CI:1.020,1.275)],TNF-αcontent[O^R=1.059(95%CI:1.011,1.176)]and NGF content[O^R=0.972(95%CI:0.778,0.998)]were the risk factors of death in patients with acute cerebral hemorrhage.Conclusion The severity of brain edema in patients with acute cerebral hemorrhage is closely related to the level of serum TNF-αand NGF.The severity of brain edema after acute cerebral hemorrhage

关 键 词：急性脑出血 脑水肿 肿瘤坏死因子-α 神经生长因子 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]