脑出血急性期血浆及脑脊液中TNF的变化

The Changes of Tunour Necrosis Factor Levels in Plasma and Cerebral Spinal Fluid After Acute Cerebral Hemorrhage

目的：探讨脑卒中时的免疫学变化，对脑出血时的血浆及脑脊液中的肿瘤坏死因子（ＴＮＦ）进行了观察。方法：对４０例患者发病后不同时间内的血浆ＴＮＦ水平进行了放射免疫法测定。同时测定了血液白细胞计数。结果：发病后ＴＮＦ显著升高，以１ｄ和３ｄ时为最高，５～１４ｄ时仍增高但幅度较低。ＷＢＣ在１ｄ时有同步性增高。脑脊液中ＴＮＦ亦有增加，但较血浆水平显著降低。出血是否破入脑室与脑脊液ＴＮＦ水平无大关系。高血压病史与ＴＮＦ变化无明确相关。结论：急性脑出血时ＴＮＦ升高是出血性损伤后白细胞及神经组织受损的免疫学应答改变，监测急性脑损伤时ＴＮＦ的变化。

Purpose:To determine the levels of tumour necrosis factor(TNF) in plasma and cerebral spinal fluid(CSF) for investigating the immunologic changes in patients with acute cerebral hemorrhage.Methods:TNF levels of plasma and CSF in 40 cases of acute cerebral hemorrhage were determined by RIA method in different time,and the leukocyte count was completed simultaneously. Results:TNF level increased significantly in plasma.It was highest at the 1st day and secondary at the 3rd day but slightly at 5～14th day ,and the leukocyte count was raised at the 1st.Level of TNF was also increased in CSF,but its extent was lesser than that in plasma.TNF level in CSF was not related with whether the hemorrhage ruptured into cerebral ventricles or not,and it was the same between TNF in CSF and patients hypertension history.Conclusion:Increasing of TNF is an immunologic response of WBC and nervous tissue to cerebral hemorrhagic lesions.Monitoring of TNF levels in plasma and CSF after cerebral injury is an important measure for understanding of the immunologic changes in nervous tissue and judging of patients Prognosis.