高血压性脑出血患者血肿周围组织肿瘤坏死因子-α表达与血清肿瘤坏死因子-α含量和细胞凋亡的关系

Relationship between the expression of tumor necrosis factor-α and the content of serum tmnor necrosis factor-α in perihematomal tissue and apoptosis in patients with hypertemive intracerebral hemorrhage

目的探讨高血压性脑出血患者血肿周围组织肿瘤坏死因子-α（tumornecrosisfactor-α，TNF-α）表达与血清TNF-α含量和血肿周围组织细胞凋亡的关系。方法30例高血压性脑出血患者根据发病到手术时间随机分为〈6h组、6～12h组、12～24h组、24～48h组、48～72h组和〉72h组（每组n=5），各组患者临床基本情况、出血量、出血部位、术前格拉斯哥昏迷量表评分和手术持续时间均无显著差异。酶联免疫吸附双抗体夹心法检测血清TNF-α含量，免疫组化法检测血肿周围组织TNF-α表达，TUNEL染色法检测血肿周围组织凋亡细胞。结果血肿周围组织TNF-α阳性细胞数量和血清TNF-α含量分别在出血后12～24h和24～48h达高峰，分别为（57．81±6．21）个／高倍视野和（78．45±7．17）pg／ml，且两者呈正相关（r=0．924，P〈0．05）；血肿周围组织TNF-α阳性细胞数量与凋亡细胞数量呈正相关（r=0．871，P〈0．05）。结论高血压性脑出血患者血清TNF-α含量显著增高，血肿周围组织TNF-α阳性细胞数量和凋亡细胞数量均显著增加。血清TNF-α含量与血肿周围组织TNF-α阳性细胞和凋亡细胞数量呈正相关。

Objective To investigate the relationship between the expression of tumor necrosis factor-α （TNF-α） and the content of serum TNF-α in perihematomal tissue and apoptosis in patients with hypertensive intracerebral hemorrhage. Methods Ihirty patients with hypertensive intracerebral hemorrhage were randomly divided into 〈6 h, 6-12 h, 12-24 h, 24- 48 h, 48-72 h and 〉 72 h groups according to the time from symptom onset to surgery （n = 5 in each group）. 3here were no significant differences among the basic clinical situation, amount of bleeding, bleeding sites, preoperative Glasgow coma scale scores and operation duration in all groups. A double-antibody sandwich enzyme-linked immunosorbent assay was used to determine the content of serum TNF-α in perihematomal tissue. Immunohistochemistry was used to detect the expression of TNF-a in perihematomal tissue, and TUNEL staining was used to detect the apoptotic cells. Results The numbers of TNF-α positive cells and the content of serum TNF-α in perihematomal tissue reached the peaks at 12-24 h and 24-48 h respectively after intracerebral hemorrhage. There was a positive correlation between them （r =0. 924, P 〈0.05）. The numbers of TNF-α positive cells in perihematomal tissue and the numbers of apoptotic cells were positively correlated （r = 0. 871, P 〈 0. 05）. Conclusions The content of serum TNF-α, the numbers of TNF-α positive cells and apoptotic cells in perihematomal tissue were increased significantly. The numbers of TNF-α positive cells in perihematomal tissue were positive correlated with the content of serum TNF-α and the numbers of apoptotic cells in perihematomal tissue.