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目的 观察脑出血患者血清中TNF-α含量,探讨其与白细胞计数(WBC)及中性粒细胞分类(N％)变化的关系。方法用放免法对32例脑出血患者的血清TNF-α分别在发病1 d、3 d、5 d行连续检测,并监测相同时间点的WBC和N％,且与21例健康者作对照分析。结果脑出血组在病程第1 d、3 d其血清TNF-α含量均高于对照组(P<0.05),第1 d达到高峰,第5 d则渐趋于正常。脑出血组在病程第1 d、3 d、5 d其WBC及N％均高于对照组(P<0.05),第3 d达高峰。随出血量增多,WBC与TNF-α及N％增加相应增多,尤以N％更明显(P<0.01)。TNF-α与WBC呈正相关(r=0.45,P<0.01)。结论TNF-α达到高峰时间比WBC要早,通过拮抗TNF-α抑制脑出血的炎症和免疫反应可能是今后防治脑出血的一个新途径。
Objective To observe the serum levels of TNF-α in patients with intracerebral hemorrhage (ICH), and to explore the relationship between the levels of TNF-α and the changes of white blood cell count (WBC) and neutrophil classification (N%). Methods The serum levels of TNF-α in 32 patients with cerebral hemorrhage were detected by radioimmunoassay at 1, 3 and 5 days respectively. The WBC and N% at the same time point were monitored and compared with 21 healthy controls . Results The level of TNF-α in the cerebral hemorrhage group was higher than that of the control group on the 1st and 3rd day of the course of disease (P <0.05). The level of TNF-α peaked on the 1st day and gradually became normal on the 5th day. The WBC and N% of cerebral hemorrhage group were higher than those of the control group on the 1st, 3rd, 5th day (P <0.05), and peaked on the 3rd day. With the increase of blood loss, WBC increased with the increase of TNF-α and N%, especially with N% (P <0.01). TNF-αwas positively correlated with WBC (r = 0.45, P <0.01). Conclusions The peak time of TNF-α is earlier than that of WBC. Inflammation and immune response to TNF-α inhibiting cerebral hemorrhage may be a new way to prevent cerebral hemorrhage in the future.