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目的:探讨血管内皮生长因子(vascularendothelialgrowthfactor,VEGF)和肿瘤坏死因子α(tumornecrosisfactorα,TNFα)在老年急性脑梗塞发病中的作用及与脑梗塞面积、神经功能缺损评分的关系。方法:应用双抗体夹心酶联免疫吸附法(ELISA)连续测定急性脑梗塞发病后3,7和14dVEGF和TNFα血清浓度,并研究其与脑梗塞面积、神经功能缺损评分的关系。结果:①VEGF和TNFα血清水平在脑梗塞发病第3,7和14天均高于对照组,高峰时间均在发病后第7天,并持续增高到发病后14d。②VEGF的血清浓度与梗塞灶的大小、神经功能缺损程度相关。VEGF与外周血白细胞明显相关。③TNFα血清浓度与梗塞灶大小、神经功能缺损程度、外周血白细胞、血脂、血小板、纤维蛋白原无相关性。结论:VEGF和TNFα在老年急性脑梗塞发病早期参与了脑梗塞病理生理过程,并可能参与了修复过程及诱导了免疫反应,该结果对急性脑梗塞的治疗具有一定指导作用。
Objective: To investigate the role of vascular endothelial growth factor (VEGF) and tumor necrosis factor α (TNFα) in the pathogenesis of acute cerebral infarction in elderly patients and their relationship with infarct size and neurological deficit score. Methods: Serum levels of VEGF and TNFα at 3, 7 and 14 days after onset of acute cerebral infarction were measured continuously by double antibody sandwich enzyme-linked immunosorbent assay (ELISA), and their relationship with cerebral infarction area and neurological deficit score were also studied. Results: ① The serum levels of VEGF and TNFα were higher than those of the control group on the 3rd, 7th and 14th days after onset of cerebral infarction. The peak time was on the 7th day after onset and continued to increase to 14 days after onset. ② VEGF concentration of serum and infarct size, the degree of neurological deficits. VEGF is clearly associated with peripheral white blood cells. ③ TNFα serum concentration and infarct size, the degree of neurological deficit, peripheral leukocytes, lipids, platelets, fibrinogen no correlation. CONCLUSION: VEGF and TNFα are involved in the pathophysiological process of cerebral infarction in the early stage of acute cerebral infarction. They may participate in the repair process and induce immune response. The results may be helpful for the treatment of acute cerebral infarction.