脑出血灶周缺氧诱导因子-1α和血清促红细胞生成素表达的相关研究

目的探讨脑出血灶周缺氧诱导因子-1α(HIF-1α)和血清促红细胞生成素(EPO)的表达及意义。方法采用免疫组化法、放射免疫法分别检测观察组患者31例脑出血灶周脑组织中HIF-1α及血清EPO的表达,并与正常对照组17例比较。结果观察组患者脑出血灶周HIF-1α表达率(41.94%)与对照组(0%)比较差异有统计学意义(P<0.01);HIF-1α随出血量增加表达随之升高,大、中量组与对照组及大量组与小量组比较差异有统计学意义(P<0.05或P<0.01)。EPO随出血量增加表达随之降低,但均高于对照组,且差异有统计学意义(P<0.05或P<0.01);大、中量组与小量组比较差异有统计学意义(P<0.01)。HIF-1α随手术时间推迟表达升高,而EPO表达和病程无相关性。HIF-1α和EPO呈负相关(r=-0.432,P<0.05)。结论脑出血后HIF-1α、EPO的表达有明显改变,在灶周低氧所致血管新生过程中可能起重要作用,可作为判断缺血半暗带存在的重要指标。

A correlation study on expression of hypoxia inducible factor-1α and serum erythropoietin in cerebral hemorrhagic lesion surrounding area

Objective To explore the expression and significance of hypoxia inducible factor-1α（HIF-1α）and serum erythropoietin （EPO） in the cerebral hemorrhagic lesion surrounding area. Methods In consecutive 31 cases of cerebral hemorrhagic, the expression of HIF-1α and serum EPO were assessed by imunohistochemistry staining and radioimmunoassay, compared with 17 cases of normal control group. Results In hemorrhage group, the expressional rate of HIF-1α was 41.94% compared with 0% in normal control group（ P 〈 0.01）.The level of HIF-1α was increased follow the volume of hemorrhagic area. There was significant difference between the massive volume group, moderate volume group and normal control group, the same result as mild volume group and massive volume group （P 〈 0.05 or P 〈 0.01）. Expression of EPO negatively related with the volume of hemorrhagic area, but still higher than normal control group（ P 〈0.05 or P 〈0.01）.There was significant difference between the massive, moderate and mild hemorrhagic volume group（ P 〈 0.01）. Expression of HIF-1α related with the regression of cerebral hemorrhage, although the expression of EPO did not. There was a negative correlation between the expression of HIF-1α and EPO （ r = -0.432, P 〈 0.05）. Coclusion Expression of HIF-1α and EPO did significantly change in cases of cerebral hemorrhage. It could have important effect in the course of perifecus leading to neovasculogenesis. They were proved to be important indexes to demonstrate isehemic penumbra exist.