蛛网膜下腔出血患者血浆肿瘤坏死因子-α和内皮素含量动态变化及其临床意义

目的 观察蛛网膜下腔出血患者血浆中肿瘤坏死因子-α(TNF-α)及内皮素(ET)水平的动态变化.方法 采用ELISA法和放免法分别测定45例蛛网膜下腔出血患者第1、3、7、14、21天的血浆TNF-α和ET水平.结果 蛛网膜下腔出血患者血浆TNF-α和ET水平较正常对照组高(均P<0.01),第3～7天升高明显,第14天降低,但第21天仍高于对照组.Hunt-Hess分级Ⅲ～Ⅴ级患者第3、14、21天血浆TNF-α和ET均较Ⅰ、Ⅱ级者高(P<0.01).结论 TNF-α和ET作为免疫因素参与了蛛网膜下腔出血的病理生理过程,提示TNF-α和ET拮抗剂治疗蛛网膜下腔出血及预防其所致脑血管痉挛将是一条可能途径.

Clinical significance of plasma TNF-α and ET levels in patients with subarachnoid hemorrhage

Objective To study the plasma TNF-α and endothelin (ET) levels in patient with subarach-noid hemorrhage(SAH). Methods The plasma TNF-α and ET levels were measured by ELISA and radioimmunity at 1,3,7,14 and 21 d after onset of SAH in 45 patients. Results The plasma TNF-α and ET levels in patients with SAH were higher than the normal controls(P<0.01),among which the highest levels appeared at 3 d and 7 d,and the levels of plasma TNF-α and ET in patients with SAH were decreased at 14 d. Those of high Hunt-Hess grade～groups was higher than those of lower grade～groups(P<0.01). Conclusion The plasma TNF-α and ET levels are significantly elevated in the patients with SAH,which suggests that TNF-α and ET may play an important role in the pathogenesis of SAH,and which suggests that is one of the possible ways to prevent and treat cardiovascular spasm (CVS) after SAH by inhibiting TNF-α and ET.