脑淀粉样血管病脑出血患者血清抗Aβ抗体检测及临床治疗

Investigation of serum anti-Aβ antibodies in cerebral amyloid angiopathy-related cerebral hemorrhage and its clinical treatment

目的探讨脑淀粉样血管病(CAA)脑出血患者血清自身抗Aβ抗体水平及亲和力的情况和临床治疗效果。方法选择2007年9月-2011年9月在本院住院的CAA脑出血患者和正常老年对照组各20例,通过间接ELISA法检测各组血清抗Aβ抗体水平及亲和力;分别采用方体定向钻颅置软管血肿排空术、开颅血肿清除术和保守治疗CAA脑出血患者26例。结果 CAA脑出血组血清抗Aβ抗体水平及亲和力均低于正常;26例患者经不同方案治疗后,14例患者痊愈,10例遗留不同程度偏瘫失语,2例死亡。结论自身抗Aβ抗体异常可能在CAA脑出血发病机制中发挥重要作用;CAA脑出血患者应根据病情选择合适的治疗方案,三种治疗方案各有其相对的适应证。

Objective To investigate serum endogenous anti-Aβ antibodies in patients with cerebral amyloid angiopathy-related cerebral hemorrhage（CAAH） and their clinical treatments.Methods The indirect ELISA was established to detect the avidity and level of serum anti-Aβ antibodies in 20 patients with CAAH and 20 healthy controls.26 patients with CAAH were treated by cubic oriented stereotactic hematoma aspiration,craniotomy and conservative treatment.Results The avidity and level of serum anti-Aβ antibodies were lower in patients with CAAH than in controls.Good outcome achieved in 14 cases,hemiplegia or aphasia in different degrees in 10 cases,and death in 2 cases.Conclusions Low avidity and level of serum anti-Aβ antibodies might play an important role in the pathogenesis of CAAH.The treatment methods for patients with CAAH should be decided according to the actual conditions.