甘露醇治疗急性脑出血患者血清血管内皮生长因子、肿瘤坏死因子-α水平的动态变化及其与脑水肿的相关性

张兴业; 贺延莉

doi:10.7619/jcmp.201916002

甘露醇治疗急性脑出血患者血清血管内皮生长因子、肿瘤坏死因子-α水平的动态变化及其与脑水肿的相关性

张兴业¹,
贺延莉^2,

1.
空军军医大学唐都医院, 神经外科, 陕西西安, 710038
2.
空军军医大学唐都医院, 放射科, 陕西西安, 710038

详细信息

通讯作者:
贺延莉

中图分类号: R743.34
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出版历程
- 收稿日期: 2019-05-12
- 录用日期: 2019-07-09
- 网络出版日期: 2021-02-28
- 发布日期: 2019-08-27

Dynamic change of serum vascular endothelial growthfactor and tumor necrosis factor-α levels in patients with acute cerebral hemorrhage treated by mannitol and correlation between encephaledema and these indexes

ZHANG Xingye¹,
HE Yanli^2,

1.
Department of Neurosurgery, Tangdu Hospital of Air Force Military Medical University, Xi′an, Shaanxi, 710038
2.
Department of Radiology, Tangdu Hospital of Air Force Military Medical University, Xi′an, Shaanxi, 710038

摘要

摘要:
目的探讨甘露醇治疗急性脑出血(AICH)患者血清血管内皮生长因子(VEGF)、肿瘤坏死因子-α(TNF-α)水平的动态变化及其与脑水肿的相关性。
方法选取AICH患者60例作为脑出血组, 另选同期健康体检者30例作为对照组。脑出血组给予甘露醇治疗，并给予降低颅内压、抗感染、营养支持等内科常规治疗。检测脑出血组入院时、入院12 h及入院1、3、10 d的VEGF、TNF-α水平，并与对照组进行比较。采用头颅CT检测脑出血组上述时间段脑水肿情况，分析血清VEGF、TNF-α水平变化与脑水肿的相关性。
结果脑出血组入院时、入院12 h以及入院1、3、10 d时血清VEGF、TNF-α水平高于对照组，差异有统计学意义(P < 0.05)。脑出血组入院3 d血清VEGF、TNF-α水平较入院时、入院12 h及入院1、10 d高，差异有统计学意义(P < 0.05)。AICH患者入院3 d绝对脑水肿体积、相对脑水肿体积较入院时、入院12 h及入院1、10 d高，差异有统计学意义(P < 0.05)。经Spearman分析可知, AICH患者血清VEGF、TNF-α水平与绝对脑水肿体积、相对脑水肿体积呈显著正相关(P < 0.05)。
结论 AICH患者的血清VEGF、TNF-α水平呈明显高表达状态, AICH患者血清VEGF、TNF-α水平与绝对脑水肿体积、相对脑水肿体积呈显著正相关。
- 急性脑出血 /
- 甘露醇 /
- 颅内压 /
- 血管内皮生长因子 /
- 肿瘤坏死因子-α /
- 脑水肿 /
- 相关性
Abstract:
Objective To explore the dynamic change of serum vascular endothelial growth factor (VEGF) and tumor necrosis factor-α (TNF-α) levels in patients with acute cerebral hemorrhage (AICH) treated by mannitol and correlation between encephaledema and these indexes.
Methods Sixty patients with AICH were enrolled as cerebral hemorrhage group, and 30 healthy subjects were selected as control group. The cerebral hemorrhage group was given routine medical treatments such as mannitol reduction of intracranial pressure, anti-infection and nutritional support as well as. The levels of VEGF and TNF-α were measured at the time points of hospital admission, 12 hours and 1, 3 and 10 days after admission in the cerebral hemorrhage group, and results were compared with control group. Cranial CT was used to detect brain edema condition at each time point in cerebral hemorrhage group, and the correlation between serum levels of VEGF, TNF-α and brain edema was analyzed.
Results The levels of VEGF, TNF-α in cerebral hemorrhage group were significantly higher than those in control group at the time points of hospital admission, 12 hours and 1, 3 and 10 days after admission (P < 0.05). In cerebral hemorrhage group, serum levels of VEGF and TNF-α at 3 days after admission were significantly higher than those at the time points of hospital admission, 12 hours and 1, 10 days after admission (P < 0.05). In the AICH patients, the absolute brain edema volume and relative brain edema volume at 3 days after admission were significantly higher than those at hospital admission, 12 hours, and 1, 10 days after admission (P < 0.05). Spearman analysis showed that serum levels of VEGF and TNF-α were positively correlated with absolute brain edema volume and relative brain edema volume in AICH patients (P < 0.05).
Conclusion The serum levels of VEGF and TNF-α are significantly over-expressed in AICH patients. Serum levels of VEGF and TNF-α are positively correlated with absolute brain edema volume and relative brain edema volume in AICH patients.
- acute cerebral hemorrhage /
- mannitol /
- intracranial pressure /
- vascular endothelial growth factor /
- tumor necrosis factor-α /
- brain edema /
- correlation

HTML全文

表 1 AICH患者血清VEGF、TNF-α水平的动态变化(x±s)

组别	时点	VEGF/(pg/mL)	TNF-α/(ng/mL)
脑出血组(n=60)	入院时	141.75±49.38^*#	3.05±0.49^*#
	入院12 h	152.08±52.76^*#	3.42±0.51^*#
	入院1 d	169.75±58.52^*#	3.61±0.55^*#
	入院3 d	208.31±96.74^*	3.98±0.62^*
	入院10 d	127.85±46.74^*#	2.81±0.42^*#
对照组(n=30)	入院时	97.35±40.28	1.37±0.15
VEGF: 血管内皮生长因子; TNF-α: 肿瘤坏死因子-α。与对照组比较, *P < 0.05; 与入院3 d比较, #P < 0.05。

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表 2 AICH患者绝对脑水肿体积、相对脑水肿体积的动态变化(x±s) cm³

时点	绝对脑水肿体积	相对脑水肿体积
入院时	15.12±0.42^*	0.97±0.35^*
入院12 h	16.57±0.63^*	1.42±0.36^*
入院1 d	17.13±0.84^*	1.57±0.41^*
入院3 d	18.26±1.39	1.68±0.39
入院10 d	10.61±0.38^*	0.67±0.21^*
与入院3 d比较, *P < 0.05。

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表 3 AICH患者血清VEGF、TNF-α水平与绝对脑水肿体积、相对脑水肿体积的相关性

项目		绝对脑水肿体积	相对脑水肿体积
VEGF	r	0.539	0.547
	P	0.008	0.006
TNF-α	r	0.439	0.451
	P	0.027	0.024
VEGF: 血管内皮生长因子; TNF-α: 肿瘤坏死因子-α。

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