血清缺氧诱导因子1α和肿瘤坏死因子α及肝细胞生长因子与脑梗死的关系

Clinical study on the relationship of hypoxia inducible factor-1 α, tumor necrosis factor-α, hepatocyte growth factor and cerebral infarction

目的 探讨缺氧诱导因子1α（HIF-1α）、肿瘤坏死因子α（TNF-α）及肝细胞生长因子（HGF）与脑梗死的关系.方法 入选2013年6-12月我院收治的急性脑梗死患者212例作为观察对象,根据脑梗死类型分为进展性脑梗死（PCI）组105例和稳定性脑梗死（SCI）组107例,选取同期100名健康体检人群作为对照,采用酶联免疫吸附法（ELISA）检测3组研究对象的HIF-1α、TNF-α及HGF;将PCI组患者按照神经功能或梗死病灶大小分组,比较各组间HIF-1α、TNF-α及HGF水平差异.结果 PCI组HIF-1α、TNF-α、HGF分别为（2.3±1.3） ng/L、（4.0±0.5）mg/L、（1.4±0.3）μg/L,显著高于SCI组[（1.1±0.5）ng/L、（3.1±1.3） mg/L、（0.7±0.4） μL]和健康对照组[（0.5 ±0.1）ng/L、（1.8±0.4）mg/L、（0.4±0.1）μ昏/L],SCI组显著高于健康对照组,差异均有统计学意义（F值分别为3.14、5.42、1.32,P均＜0.01）;PCI轻度组患者HIF-1α、TNF-α、HGF分别为（0.7±0.3） ng/L、（2.9±0.3）mg/L、（0.7±0.5）μg/L,均显著低于中度组[（1.4±0.5）ng/L、（4.9±0.5）mg/L、（1.7±0.4）μg/L]和重度组[（1.4±0.5） ng/L、（4.9±0.5）mg/L、（1.9±0.4） μg/L,中度组显著低于重度组,差异均有统计学意义（F值分别为0.93、4.32、2.31,P均＜0.01）;PCI小梗死灶组患者HIF-1α、TNF-α、HGF分别为（0.6 ±0.4）ng/L、（2.7 ±0.4）mg/L、（0.7±0.4）μg/L,均显著低于中梗死灶组[（1.1±0.5）ng/L、（4.4±0.5） mg/L、（1.1±0.2）μg/L]和大梗死灶组[（1.4±0.6）ng/L、（4.8±0.6）mg/L、（1.9±0.5）μg/L];中梗死灶组显著低于大梗死灶组,差异均有统计学意义（F值分别为4.71、2.09、2.45,P均＜0.01）.结论 进展性脑梗死患者血清HIF-1仪、TNF-α及HGF水平明显增高,且各指标与进展性脑梗死神经功能缺损程度及梗死灶大小关系密切.

Objective To investigate the relationship of hypoxia inducible factor-1 α（HIF-1α）,tumor necrosis factor-α （TNF-α）,hepatocyte growth factor （HGF） and cerebral infarction.Method Two hundred and twelve cases with acute cerebral infarction in the Fourth People＇s Hospital of Langfang from Jun.to Dec.2013 were divided into progressive cerebral infarction（PCI） group（n =105） and the stability of cerebral infarction （SCI） group （n =107）.Meanwhile 100 healthy people were served as control group.Enzyme-linked immunosorbent assay（ELISA） was applied to detect the levels of HIF-1 α,TNF-α and HGF.The PCI group were divided into small groups according to nerve function or infarction lesion size,and the levels of HIF-1 α,TNF-α and HGF of each group.Result The levels of HIF-1 α,TNF-α,HGF in PCI group were （2.3 ± 1.3） ng/L,（4.0 ± 0.5） mg/L and （1.4 ± 0.3） μg/L,significantly higher than those in SCI group （（1.1 ± 0.5） ng/L,（3.1 ±1.3） mg/L and （0.7 ±0.4） μg/L;F=5.42） and control group（（0.5 ±0.1） ng/L,（1.8 ±0.4） mg/L and （0.4 ±0.1） μg/L;F =3.14）.Meanwhile,the levels of HIF-1 α,TNF-α,HGF in SCI group was significantly higher than that of the control group （F =1.32,P 〈 0.05）.The levels of HIF-1α,TNF-α,HGF in mild PCI group were significantly lower than those in moderate group and severe group,and those in moderate group was lower than those in severe group （F =0.93,4.32,2.31 ; P 〈 0.01）.The levels of HIF-1 α,TNF-α,HGF in small infarction group were （0.6 ± 0.4） ng/L,（2.7 ± 0.4） mg/L,（0.7 ± 0.4） μg/L,significantly lower than those in infarction group （（1.1 ± 0.5） ng/L,（4.4 ± 0.5） mg/L,（1.1 ± 0.2） μg/L; F =4.71,P〈0.05） and large infarction group（（1.4 ± 0.6） ng/L,（4.8 ± 0.6） mg/L,（1.9 ± 0.5） μg/L; F =2.09,P〈0.05）.The levels of HIF-1α,TNF-α,HGF in focal infarction group was significantly lower than that in large infarction group and the difference is statistically significant（F =2.45,P 〈0.05）.Conclusion HIF-1 α,TNF-α and HGF serum levels in progressive cerebral infarction are significantly increased,which is related to the function defect and size of infarction.