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目的 研究急性脑梗死 (ACI)患者血清肿瘤坏死因子 (TNF)及循环内皮细胞 (CEC)含量的变化 ,探讨 TNF与 CEC的关系及其临床意义。方法 采用放射免疫分析法检测 6 0例 ACI患者血清 TNF- α和 CEC的含量 ,并与 2 0例健康人作对照。结果 (1)脑梗死患者急性期血清 TNF- α和 CEC含量明显高于恢复期 (P<0 .0 1)。恢复期血清 TNF- α及 CEC则高于正常水平 (P<0 .0 1)。 (2 )脑梗死急性期血清 TNF- α和 CEC升高的程度与梗死灶大小密切相关 (P<0 .0 1)。 (3)急性期血清 TNF- α与 CEC呈正相关 (r=0 .6 9,P<0 .0 1)。结论 ACI患者血清TNF- α及 CEC含量升高 ,提示 TNF- α及血管内皮细胞的损伤共同参与脑梗死的发生发展过程。保护血管内皮细胞 ,降低 TNF- α的水平 ,对于缺血性脑血管病的防治将具有重要意义。
Objective To study the changes of serum tumor necrosis factor (TNF) and circulating endothelial cells (CEC) in patients with acute cerebral infarction (ACI) and to explore the relationship between TNF and CEC and its clinical significance. Methods The levels of serum TNF-α and CEC in 60 ACI patients were detected by radioimmunoassay, and compared with 20 healthy people. Results (1) Serum levels of TNF-α and CEC in patients with acute cerebral infarction were significantly higher than those in patients with recovery (P <0.01). The level of serum TNF-α and CEC in convalescence stage were higher than normal (P <0.01). (2) The level of serum TNF-α and CEC in acute stage of cerebral infarction is closely related to the size of infarction (P <0.01). (3) There was a positive correlation between serum TNF-α and CEC in acute phase (r = 0.69, P <0.01). Conclusion The serum levels of TNF-α and CEC in patients with ACI are increased, suggesting that TNF-α and vascular endothelial cell injury are involved in the development of cerebral infarction. Protecting vascular endothelial cells, reducing the level of TNF-α, for the prevention and treatment of ischemic cerebrovascular disease will be of great significance.