PTX-3在蛛网膜下腔出血后脑血管痉挛发病机制中的作用

Role of pentraxin-3 in pathogenesis with cerebral vasospasm after subarachnoid hemorrhage

目的探讨正五聚蛋白-3(PTX-3)在蛛网膜下腔出血(SAH)后脑血管痉挛(CVS)发生过程中的作用机制。方法分别检测SAH患者和健康对照组外周血白细胞(WBC)、中性粒细胞百分比(NE%)和脑脊液(CSF)中WBC、PTX-3水平。结果 SAH患者外周血WBC、NE%和CSF WBC、多个核细胞数均显著高于健康对照组(P<0.01,P<0.05);并且,血清和CSF PTX-3水平也显著高于健康对照组(P<0.01,P<0.05)。SAH患者痉挛组WBC、NE%与未痉挛组相比,差异无统计学意义(P>0.05),与之相反,SAH患者痉挛组CSF WBC、多个核细胞数显著高于未痉挛组,差异具有统计学意义(P<0.05),值得关注的是,血清PTX-3水平与未痉挛组相比,差异无统计意义(P>0.05),而CSF PTX-3水平显著高于未痉挛组(P<0.01)。SAH患者痉挛组WBC、NE%和CSF WBC、多个核细胞数在1、2、3、5、7d均显著高于健康对照组,差异具有统计学意义(P<0.01);并且,SAH患者痉挛组血清和CSF PTX-3水平在1、2、3、5、7d均显著高于健康对照组,差异具有统计学意义(P<0.01)。结论 SAH患者机体存在高强度的全身和局部炎症反应。局部炎症反应与CVS的发生密切相关。CSF高水平PTX-3可能通过诱导局部炎症反应而介导CVS的发生。CVS的发生依赖于患者机体高强度炎症反应的持续存在,而PTX-3可能是介导高强度炎症反应持续存在的关键效应分子。

Objective To investigate the mechanism of pentraxin-3（PTX-3）in pathogenesis of cerebral vasospasm（CVS）after subarachnoid hemorrhage（SAH）.Methods The levels of white blood cell（WBC）,neutrophil percentage（NE%）and PTX-3in cerebrospinal fluid（CSF）and peripheral blood from SAH patients and healthy subjects were detected respectively.Results WBC and NE%levels of peripheral blood and CSF in SAH group were significantly higher than healthy controls（P0.01,P0.05）.Serum and CSF PTX-3levels in SAH group were significantly higher than healthy controls（P0.01,P0.05）.CSF levels of WBC,NE% and PTX-3in SAH patients with CVS were higher than SAH patients without CVS（P0.05）,but the difference of serum PTX-3level was not significant（P0.05）.On 1,2,3,5and 7days after SAH,CSF and peripheral blood levels of WBC,NE%and PTX-3in patients with CVS were significantly higher than healthy controls（P0.01）.Conclusion The pathogenesis of CVS might be with high level systemic and local inflammatory response in SAH patients.High level of PTX-3in CSF might mediate the onset of CVS by inducing local inflammatory reaction.The occurrence of CVS could be dependent on the persistence of highly intensive inflammatory response,of which PTX-3might be the key mediating molecule.