急性脑出血患者血清炎性因子与血肿周围低密度的关系

Relation between serum inflammatory markers and perihematoma hypodensity in patients with intracerebral hemorrhage

目的观察急性脑出血患者血清炎性因子含量变化与血肿周围低密度的相关性.方法42例急性脑出血患者(脑出血组)行血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、P-选择素(Ps)及S-100蛋白检测,CT检查动态观察血肿及其周围低密度的变化.对照组为同期住院的25例非神经系统器质性疾病患者.结果脑出血组患者入院时血清TNF-α、IL-1β、Ps、S-100水平较对照组显著增高.单因素分析显示,TNF-α(r=0.678,P＜0.001)、IL-1β(r=0.423,P=0.011)、Ps(r=0.458,P=0.006)与血肿周围低密度均有显著相关性,logistic回归分析显示,TNF-α水平为影响血肿周围低密度的惟一因素(OR=3.694,95%CI:1.670～8.173,P=0.001).结论急性脑出血患者血清炎性因子TNF-α、IL-1β、Ps及S-100水平显著增高,患者入院时血清TNF-a水平与血肿周围脑水肿密切相关.

Objective To investigate the relationship between serum markers of inflammation and brain injury after acute intracerebral hemorrhage （ ICH）. Methods Blood samples of 42 consecutive patients with acute ICH were collected for measurement of tumor necrosis-α（TNF-α）, interleukin-1β（IL-1β）, P-selectin（Ps） and S-100 protein（S-100） levels. The volumes of ICH, peripheral edema were measured on CT scan. The control group consisted of 25 inpatients without organic diseases in central nervous system. Results Admission blood concentrations of TNF-α, IL-1β,Ps and S-100 in ICH patients were significantly higher than those in controls. Univariate analysis revealed a significant correlation between the volume of the perihematoma hypodensity on day 3 and TNF-α（ r =0.678, P 〈0.001）,IL-1β（ r =0.423, P =0.011）,Ps（ r =0.458, P =0.006） levels. In logistic regression analysis, TNF-α concentration （ OR = 3. 694,95 % CI ： 1. 670 - 8. 173, P = 0. 001 ） was the only variable that significantly influenced the volume of the perihematoma hypodensity. Condusions The markers of inflammation TNF-α, IL-1β, Ps and S-100 levels were significantly increased in patients with ICH. High plasma level of TNF-α in patients with ICH could be correlated with the magnitude of the subsequent increased perihematoma brain edema.