老年急性脑梗塞患者血清血管内皮生长因子和肿瘤坏死因子α水平的动态变化研究

Vascular endothelial growth factor and tumor necrosis factor-α in serum of geriatric patients with acute cerebral infarction

目的:探讨血管内皮生长因子(vascularendothelialgrowthfactor,VEGF)和肿瘤坏死因子α(tumornecrosisfactorα,TNFα)在老年急性脑梗塞发病中的作用及与脑梗塞面积、神经功能缺损评分的关系。方法:应用双抗体夹心酶联免疫吸附法(ELISA)连续测定急性脑梗塞发病后3,7和14dVEGF和TNFα血清浓度,并研究其与脑梗塞面积、神经功能缺损评分的关系。结果:①VEGF和TNFα血清水平在脑梗塞发病第3,7和14天均高于对照组,高峰时间均在发病后第7天,并持续增高到发病后14d。②VEGF的血清浓度与梗塞灶的大小、神经功能缺损程度相关。VEGF与外周血白细胞明显相关。③TNFα血清浓度与梗塞灶大小、神经功能缺损程度、外周血白细胞、血脂、血小板、纤维蛋白原无相关性。结论:VEGF和TNFα在老年急性脑梗塞发病早期参与了脑梗塞病理生理过程,并可能参与了修复过程及诱导了免疫反应,该结果对急性脑梗塞的治疗具有一定指导作用。

]Objective:To investigate the role of serum vascular endothelial growth factor(VEGF) and tumor necrosis factor-α(TFN-α) and their relation to infarct volume and clinical disability in geriatric patients with acute cerebral infarction.Methods: The serum levels of VEGF and TNF-α in 40 geriatric patients with acute ischemic stroke were serially (on days 3,7,and 14) measured using standard quantitative sandwich ELISA (Quantikine) kits. Results : ①Expressions of VEGF and TNF-α were significantly increased in the geriatric patients after acute stroke at each of the time points compared with normal controls.The highest expression occurred on day 7,and they remained significantly elevated on day 14 after stroke.②Expression of VEGF correlated with infarct volume,clinical disability and peripheral leukocytosis.③In contrast,expression of TNF-α did not correlate with infarct volume,clinical disability and peripheral leukocytosis.Conclusion: VEGF and TNF-α showed a dramatic increase in serum of stroke geriatric patients.VEGF and TNF-α may play an important role in the pathophysiology of acute ischemic stroke and may be involved in the subsequent repair processes resulting in recovery after stroke.The measurement of serum levels of VEGF and TNF-α may be helpful to directing the treatment strategy in future.