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目的探讨血管内皮生长因子(VEGF)和肿瘤坏死因子-α(TNF-α)在急性脑出血患者中的动态变化及意义。方法分别采用双抗体夹心ELISA法和平衡放射免疫法测定32例急性脑出血患者发病24h内、7d、14d时和30名健康对照者的血清VEGF和TNF-α水平,并对其进行相关性分析。结果①脑出血组血清VEGF和TNF-α明显高于正常对照组(P<0.05),脑出血发生后24h内血清VEGF和TNF-α即开始升高,在7d时达高峰,14d时仍维持较高水平。②脑出血组血清VEGF和TNF-α水平与血肿量大小及病情轻重有关血肿量越大,血清VEGF和TNF-α水平越高,但是血清TNF-α水平与血肿量的大小有相关性(P<0.05),血清VEGF水平与血肿量的大小无相关性(P>0.05)。③血肿周围水肿体积的大小与血清VEGF和TNF-α水平有相关性(r=0.400,P<0.05;r=0.828,P<0.001)。结论血清VEGF和TNF-α在脑出血发生后呈动态变化,并与血肿周围水肿体积大小相关,提示VEGF和TNF-α参与了急性脑出血后的病理过程。
Objective To investigate the dynamic changes of vascular endothelial growth factor (VEGF) and tumor necrosis factor-α (TNF-α) in patients with acute cerebral hemorrhage. Methods Serum levels of VEGF and TNF-α in 32 patients with acute intracerebral hemorrhage at 24h, 7d, 14d and 30 healthy controls were measured by double antibody sandwich ELISA and balanced radioimmunoassay, respectively, and their correlations were analyzed . Results ① The serum levels of VEGF and TNF-α in cerebral hemorrhage group were significantly higher than those in normal control group (P <0.05). Serum VEGF and TNF-α began to increase within 24 hours after intracerebral hemorrhage and peaked at 7th day Higher level. ② The levels of serum VEGF and TNF-α in cerebral hemorrhage group were correlated with the amount of hematoma and the severity of hematoma. The higher the level of serum VEGF and TNF-α, the higher the level of serum TNF-α was (P <0.05). There was no correlation between the level of serum VEGF and the amount of hematoma (P> 0.05). The volume of edema around hematoma was correlated with the level of serum VEGF and TNF-α (r = 0.400, P <0.05; r = 0.828, P <0.001). Conclusions Serum levels of VEGF and TNF-α are dynamically changed after cerebral hemorrhage and correlated with the volume of edema around the hematoma, suggesting that VEGF and TNF-α are involved in the pathological process after acute intracerebral hemorrhage.