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目的观察急性脑梗塞患者血清肿瘤坏死因子-α(TNF-α)水平的动态变化,探讨TNF-α在脑梗塞发病机制中的作用及临床意义。方法采用放射免疫分析法连续检测50例急性脑梗塞患者发病第1、3、7和28d血清肿瘤坏死因子-α水平,并与28例短暂性脑缺血发作患者和30例正常对照组进行比较。结果急性脑梗塞患者于发病第1dTNF-α开始升高(P<0.05),第3d达峰值水平(P<0.01),然后逐渐下降,至第28d时仍高于对照组和短暂性脑缺血发作组(P<0.05);梗死体积越大,TNF-α水平越高,与其他各组相比差异有统计学意义(P<0.05或P<0.01)。短暂性脑缺血发作组患者血清TNF-α与正常对照组之间差异无统计学意义(P>0.05)。结论 TNF-α水平的动态变化与急性脑梗塞的发生发展有关,TNF-α水平与梗死灶体积有关,TNF-α参与脑梗塞患者炎症/免疫反应发生发展过程。
Objective To observe the dynamic changes of serum tumor necrosis factor-α (TNF-α) in patients with acute cerebral infarction and to explore the role of TNF-α in the pathogenesis of cerebral infarction and its clinical significance. Methods Serum levels of tumor necrosis factor-α on the 1st, 3rd, 7th and 28th day of 50 acute cerebral infarction patients were detected by radioimmunoassay, and compared with 28 patients with transient ischemic attack and 30 normal controls . Results The levels of TNF-α began to increase (P <0.05) on the first day of onset in patients with acute cerebral infarction, reaching the peak value on the third day (P <0.01), then gradually decreased and remained higher than that of the control group and transient cerebral ischemia (P <0.05). The larger the infarct volume, the higher the level of TNF-α, the difference was statistically significant compared with other groups (P <0.05 or P <0.01). There was no significant difference between serum TNF-α and normal control group in transient ischemic attack group (P> 0.05). Conclusions The dynamic change of TNF-α level is related to the occurrence and development of acute cerebral infarction. The level of TNF-α is related to the infarct size. TNF-α is involved in the development of inflammatory and immune responses in patients with cerebral infarction.