脑出血患者TNF-α表达及其临床意义.docVIP

脑出血患者TNF-α表达及其临床意义[摘要] 目的 观察脑出血患者TNF-α蛋白的表达情况,探讨TNF-α蛋白在脑出血患者中表达特点与脑出血时间的关系和意义。方法 应用免疫组化方法检测65例脑出血患者出血灶周围脑组织TNF-α蛋白的表达。结果 65例脑出血灶周边脑组织标本中,TNF-α蛋白阳性表达率为84.6%(55/65),10例正常脑组织中TNF-α蛋白阳性表达率为0(0/10),两者比较有显著性差异(P24h 88.9%(16/18),出血组之间比较无差异(P0.05)。结论 脑出血急性期血肿周围组织存在TNF-α高表达,且有大量炎性细胞浸润,以中性粒细胞、淋巴细胞为主。TNF-α参与了脑出血脑水肿的病理生理过程,从而加重血肿周围脑组织的损害。 [关键词] TNF-α蛋白;脑出血;免疫组化 [中图分类号] R743.34 [文献标识码] A [文章编号] 1673-9701(2010)06-36-02 TNF-αExpression in Intracerebral Hemorrhage and Its Clinical Significance YANG Yanli1WEI Maofu2LIU Jingwen2 1. Third Department of Medicine, Dongguan Municipal Humen Hospital,Dongguan 523900,China;2. Department of Pathology,Dongguan Municipal Humen Hospital,Dongguan 523900,China [Abstract] Objective To investigate the expression of TNF-α in intracerebral hemorrhage(IHC) and find out its significance and its correlation with the time of intracerebral hemorrhage.Methods The TNF-αexpression was assessed by immunohistochemistry staining.Results In 65 cases of intracerebral hemorrhage,the positive expression rate of TNF-α was 84.6%(55/65) and in 10 cases of normal brain tissue, it was 0(0/10), significantly higher in intracerebral hemorrhage than that in normal brain tissue(P0.05).Conclusion The high TNF-αexpression appears in the surrounding tissue of cerebral hematoma after acute cerebral hemorrhage with a large number of inflammatory cell infiltration in it,mainly leukocyte and lymphocyte infiltration.TNF-α may be involved in the pathophysiologic process of brain edema after intracerebral hemorrhage,therefore,aggravating brain damage around hematoma. [Key words] TNF-α;Intracerebral hemorrhage;Immunohistochemistry 脑出血(ICH)是神经内科很常见的疾病,死亡率和致残率较高。目前,脑出血导致脑水肿的发病机制尚未完全明了。很多学者认为导致脑水肿的原因与炎性因子密切相关,其中包括肿瘤坏死因子(TNF-α)。有研究表明TNF-α在脑损伤后表达升高,其升高程度与脑损伤严重程度关系密切[1]。我们采用免疫组织化学技术对65例脑出血患者和10例正常脑组织中TNF-α表达的情况进行研究,探讨TNF-α在脑出血灶周的表达特点及意义。 1材料与方法 1.1标本来源 收集陕西省延安市人民医院和延安大学附属医院2003年1月～2006年12月期间进行手术清除血肿的脑出血患者65例,男28例,女37例,年龄25～83岁,平均48.6岁。手术时机:发病24h内手术者47例,24h后