急性脑梗塞患者血清TNF-α的测定及临床意义.docVIP

急性脑梗塞患者血清TNF-α的测定及临床意义 　　摘要：目的 探讨急性脑梗塞患者血清肿瘤坏死因子-α（TNF-α）动态变化及临床意义。方法 用Elisa法检测60例急性脑梗塞患者发病第1、3、6、18d TNF-α 水平，并与20例正常对照组进行比较。结果 急性脑梗塞患者神经功能缺损程度越高，血清TNF-α水平越高，各组间比较差异显著（P＜0.05）；急性脑梗塞患者梗塞面积越大，血清TNF-α水平越高，各组间比较差异显著（P＜0.05）。结论 TNF-α介导的免疫反应参与急性脑梗塞的发展过程，对血清TNF-α水平的动态观察可作为急性脑梗塞早期诊断及病情判断的参考依据。 　　关键词：急性脑梗塞；肿瘤坏死因子-α；炎症反应 　　 　　Clinical significance and determination of serum TNF-α inpatients with acute cerebral infarction 　　HuangXianglingTAO Fei.WU Xiao-Di,LING Jian-Hen.FOshan-changcheng Hospital Affiliated to Guangdong Medicine College 528301 　　 Abstract Objective To evaluate the clinical significance and determination of serum TNF-α inpatients with acute cerebral infarction. Methods The concentration of serum TNF-α were measured by Elisa in 60 cases with acute cerebral infarction, and the results were compared with those in 20 healthy cases. Results As the focal infarction size presented more larger and the serum TNF-α level would be more higher, showed significant differences between each group (P0.05). As the nerve function defect more higher and the serum TNF-α level would be more higher, showed significant differences between each group (P0.05).Conclusion The immune response is mediated by TNF-α participate in the development of acute cerebral infarction, dynamic observation to the level of serum TNF-α can be used as early diagnosis and condition judgment of acute cerebral infarction. 　　Keyword: acute cerebral infarction; tumor necrosis factor-α; inflammatory response 　　 急性脑梗塞（acute cerebral infarction，ACI）是由于脑动脉血管内膜损伤、动脉粥样硬化等因素造成脑动脉血管管腔狭窄、堵塞或形成血栓，脑部组织缺血、缺氧甚至坏死，从而导致患者神经功能受损[1]。急性脑梗塞属于常见急重症之一，具有发病急、致残率高、致死率高等特点，严重影响患者生命健康及生活质量[2]。近年来研究表明，机体免疫细胞因子与急性脑梗塞的发生、发展过程密切相关，但血清中TNF-α与急性脑梗塞的动态关系鲜见报道[3-4]。本研究通过对比分析急性脑梗塞不同神经功能缺损程度、不同梗塞面积与患者血清TNF-α水平之间的关系，旨在探讨血清TNF-α水平在急性脑梗塞患者诊断及治疗中的临床价值。 　　1 资料与方法 　　1.1 一般资料选取2013年1月至2013年8年我院收治的急性脑梗塞患者共60例为实验组，男性38例，女性22例；年龄43岁～65岁，平均年龄（50.2±8.5）岁。所有入组患者均行CT、MRI检查，且均符合1995年成都第四届全国脑血管病学术会议修订的脑梗塞诊断标准[5]。排除标准：①心、肝、脾、肺、肾等重要脏器功能不全者；②合并恶性肿瘤者；③合并