蛛网膜下隙出血并发脑血管痉挛患者脑脊液中转铁蛋白及其可溶性受体变化与意义

Research on the Change of Transferrin and Soluble Transferrin Receptor in Cerebrospinal Fluid of the Cerebral Vasospasm Patients after Subarachnoid Hemorrhage

目的:探讨脑内铁转运系统与脑血管痉挛(CVS)的可能关系。方法:收集43例蛛网膜下隙出血(SAH)患者脑脊液(CSF),利用ELISA法测定转铁蛋白(Tf)和可溶性转铁蛋白受体(sTfR)浓度。结果:所有SAH患者的CSF中Tf浓度在出血后5、7、10 d时与当天比明显升高(P<0.01),而sTfR浓度无明显改变。在并发CVS患者的CSF中Tf浓度在出血后5、7、10 d时较未发生CVS者比显著升高(P<0.01)。结论:SAH患者CSF中的Tf升高,不是血液中的Tf进入CSF中引起,而是脑组织受红细胞分解产物刺激合成分泌所致。推测Tf的升高在SAH并发CVS有重要作用,其变化可以作为判断SAH后是否发生CVS的重要指标。

Objective： To expound the possible relationship between iron transport and cerebral vasospasm（CVS）. Methods： The cerebrospinal fluid（ CSF） of 43 patients with subarachnoid he morrhage（SAH）was collected, and the concentrations of transferrin（Tf）and soluble transferrin receptor（sTfR）were detected by ELISA. Results： The level of Tf in CSF was significantly increased at day5, 7and day10 compared to Tf in CSF at dayl in all SAH patients（ P 〈 0.01）, but there was no change in the level of sTfR in CSF. The level of Tf in CSF of the vasospasm group was higher than that of non vasospasm group at dayS, 7 and day10（P 〈 0.01）. Conclusion： Tf in CSF is synthesized and secreted by brain. The level of Tf may be the critical factor for CVS after SAH. It could be an indicator for CVS.