急性脑出血患者血清炎症因子和氧化应激产物的动态监测及其临床意义

Dynamic monitoring of serum inflammatory cytokines and products of oxidative stress in patients with acute intracerebral hemorrhape

目的 对急性脑出血（AICH）患者血清炎症因子和氧化应激产物水平进行动态监测,探讨急性脑出血后炎症反应与氧化应激的关系及其与疾病的病程及预后的关系.方法 选择80例确诊为AICH的患者为研究对象,于入院后24h内、25～48h、49～72h、7d、14d分别抽取患者肘静脉血,采用双抗体夹心（ELISA）测定血清炎症因子IL-6及TNF-α水平,黄嘌呤氧化酶法和硫代巴比妥酸法分别测定血清氧化应激产物超氧歧化酶（SOD）和丙二醛（MDA）水平,并于同期进行健康体检的60例正常人群血清IL-6、TNF-α、SOD、MDA进行比较.结果 AICH患者血清IL-6、TNF-α水平、MDA水平24h内即明显上升,至49～72h内达最高值,7d时逐渐下降,14d时基本接近正常;而血清氧化应激产物SOD水平在24h内即开始下降,至49～72h达最低值,而7d时逐渐升高,至14d时基本恢复,与对照组比较差异无统计学意义.结论 动态监测血清炎症因子和氧化应激产物变化有利于对脑出血后脑水肿及脑损伤程度的判断以及病情与预后的判定.

Objective To monitor the serum levels of inflammatory cytokines and products of oxidative stress in patients with acute cerebral hemorrhage （AICH）,and discuss the relationship of inflammation and oxidative stress in the pathogenesis of related complication of AICH.Methods 80 cases of patients with AICH were involved in the study and their cubital vein blood of 24h after admission,25 ～ 48h,49 ～ 72h,7d,and 14d were taken.Serum inflammatory factors IL-6 and TNF-α were tested using double antibody sandwich enzyme-linked immunosorbent assay ELISA）,and serum levels of products of oxidative stress,superoxide dismutase （SOD） and malondialdehyde MDA） were measured with xanthine oxidase and thiobarbituric acid methods.All of the results were compared to that of normal people.Results Serum levels of IL-6,NF-α and MDA were increased significantly within 24h and peaked within 49～72h,and began to decrease at day 7.At day 14,serum IL-6,NF-α and MDA were all almost returned to the normal.While serum SOD level began to decline within 24h and reached its lowest value within 49～72h and began to increase at day 7,returning to its normal value at day 14,without significant difference compared to control group.Conclusion The results suggested that the inflammatory cytokines,oxidative stress may have a function in the development of brain damage after intracerebral hemorrhage.