脑出血后人颅内血肿中HO-1、UCB和Fe的含量及其与迟发性脑水肿的关系

The Changes in HO-1,UCB and Fe in the Intracranial Hematoma and Their Relation with Delayed Cerebral Edema Following Cerebral Hemorrhage

目的研究高血压脑出血后人颅内血肿中的血红素加氧酶-1(HO-1)和血红蛋白代谢产物——非结合胆红素(UCB)和铁(Fe)的含量变化,及其与脑出血后迟发性脑水肿的相关性,初步探讨脑出血后迟发性脑水肿形成的病理生理机制。方法用酶联免疫吸附试验(ELISA)、钒酸盐氧化法和化学酶法试剂检测高血压脑出血患者颅内血肿微创术后第1、3、6天颅内血肿引流物中的HO-1、UCB和Fe的含量,并应用多田公式计算术后第3天和第6天血肿周围脑水肿的体积,分析它们之间的相关性。结果颅内血肿中的HO-1、UCB和Fe的含量在脑出血后第3天明显增高,并达到高峰,第6天有所下降,与第1天比较差异均有显著性意义(均P<0.01)。而第6天HO-1、UCB和Fe的含量与第6天血肿周围脑水肿的体积均呈正相关(r分别为0.453、0.525、0.691,均P<0.05)。结论HO-1和血红蛋白代谢产物UCB及Fe在脑出血后迟发性脑水肿的形成中起着重要作用。

Objective To detect the changes in heme oxygenase-1（HO-1）,unconjugated bilirubin（UCB） and ferrum（Fe） in the intracranial hematoma,and investigate their roles in the pathophysiological mechanisms of the delayed cerebral edema after cerebral hemorrhage.Methods Thirty cases of cerebral hemorrhage received minimally invasive operation,and the contents of HO-1,UCB and Fe in the hematoma were detected at the first,third and sixth day after the operation.Twenty healthy adults served as the control group.The volume of cerebral edema was measured at the third and sixth day.Results The contents of HO-1,UCB and Fe were increased at the third day and reached the peak,much higher than those at the first day（P〈0.01）.The contents of HO-1,UCB and Fe at the sixth day were decreased,but still higher than at the first day（P〈0.01）.The contents of HO-1,UCB and Fe at the sixth day were correlated with the volume of cerebral edema in the same day（r=0.453,0.525,0.691 respectively,P〈0.05）.Conclusion HO-1,UCB and Fe may play important roles in the mechanisms of the delayed cerebral edema after cerebral hemorrhage.