三七总皂甙对急性脑梗死患者血清TNF-α和IL-6水平的影响

Effects of panax notoginseng saponins on serum TNF-α and IL-6 levels in patients with acute cerebral infarction

目的:观察三七总皂甙(PNS)对急性脑梗死患者血清TNF-α和IL-6水平的影响,探讨三七总皂甙的脑保护机制。方法:选择发病7d内的脑梗死患者62例,随机分为PNS干预组(常规药物治疗加三七总皂甙)32例,对照组(常规药物治疗)30例。采用放射免疫分析法测定血清细胞因子TNF-α,IL-6含量,观察两组治疗前后血清细胞因子TNF-α、IL-6活性水平;美国国立卫生研究院卒中量表(NIHSS)及Barthel指数评分法分别评估两组治疗前后神经功能缺损评分及日常生活活动能力评分。结果:治疗前,PNS组和对照组血清TNF-α,IL-6活性水平相比差异无显著性(P>0.05),两组NIHSS评分、Barthel指数评分之间差异无显著性意义(P>0.05);治疗3周后,PNS组血清TNF-α,IL-6活性水平比对照组显著降低(P<0.05),NIHSS评分比对照组显著改善(P<0.01),Barthel指数评分则明显比对照组高(P<0.01)。PNS组的血清TNF-α,IL-6活性水平与NIHSS评分呈明显正相关(分别为r=0.741,P<0.05;r=0.732,P<0.05),与Barthel指数评分显著负相关(分别为r=-0.767,P<0.05;r=-0.809,P<0.05)。结论:三七总皂甙可能通过抑制脑梗死后TNF-α,IL-6介导的炎症反应,促进功能恢复。

Objective：To observe the effects of panax notoginseng saponins （PNS） on serum TNF-α and IL-6 levels in patients with acute cerebral infarction, and investigate the neuroprotection of PNS in acute cerebral infarction. Method-Sixty-two patients with acute cerebral infarction were randomly divided into two groups： PNS group （n=32, treated by PNS for 3 weeks in addition to the routine medications） and control group （n=30, treated by routine medications）. The serum levels of TNF-α and IL-6 was determined by radioimmunoassay, the scores of neurological dysfunction and activities of daily living were evaluated by the NIHSS and BI. The levels of serum TNF-α and IL-6 and scores of NIHSS and BI were assessed before and after PNS treatment, respectively.Result： Before treatment, there were no significant difference in the content of serum TNF-α and IL-6 and scores of NIHSS and BI between PNS group and control group. However, after 3 weeks of treatment, the levels of TNF-α and IL-6 and scores of NIHSS in PNS group were significantly lower than those of control group （P〈0.05）, while scores of BI in PNS group were significantly higher than that of control （P〈0.05）. The levels of TNF-α and IL-6 showed a positive correlation with the scores of NIHSS（r=0.741, P〈0.05, r=0.732, P〈0.05）, and showed a negative correlation with the scores of BI （r=-0.767,P〈0.05;r=-0.809,P〈0.05）. Conclusion： PNS has an anti-inflammatory effect and can promotes rehabilitation in patients with acute cerebral infarction.