血清肿瘤坏死因子-α、神经生长因子与急性脑出血后脑水肿程度及预后的关系

Relationship of serum level of TNF-α and NGF with degree of brain edema and prognosis after acute cerebral hemorrhage

摘要:

目的 探讨血清肿瘤坏死因子-α（TNF-α）、神经生长因子（NGF）与急性脑出血后脑水肿程度及预后的关系。方法 选取2014年1月—2018年6月解放军总医院第七医学中心收治的急性脑出血患者200例为研究对象，根据脑水肿体积将患者分为轻度水肿组（68例)、中度水肿组（70例）及重度水肿组（62例），检测并比较3组患者不同时间点血清TNF-α、NGF质量浓度。根据预后情况将患者分为存活组（172例）和死亡组（28例）。采用Pearson法分析血清TNF-α、NGF与患者脑水肿严重程度的相关性，用Logistic回归模型分析患者预后的影响因素。结果 3组不同时间点的TNF-α和NGF质量浓度有差异（P?<0.05）；3组的TNF-α和NGF质量浓度有差异（P?<0.05），随着脑水肿严重程度的升高患者血清TNF-α和NGF质量浓度升高；3组的TNF-α和NGF质量浓度变化趋势有差异（P?<0.05）。存活组TNF-α、NGF质量浓度均低于死亡组（P?<0.05）。TNF-α（r?=0.462，P?<0.05）、NGF（r?=0.491，P?<0.05）与急性脑出血后脑水肿严重程度呈正相关。脑水肿严重程度（OlR=1.091，95% CI：1.020，1.275）、TNF-α（OlR=1.059，95% CI：1.011，1.176）、NGF（OlR=0.972，95% CI：0.778，0.998）是急性脑出血患者死亡的危险因素。结论 急性脑出血患者脑水肿严重程度与血清TNF-α、NGF相关，检测上述指标可评估急性脑出血后脑水肿病情严重程度。

Abstract:

Objective To investigate the relationship of serum level of tumor necrosis factor-α (TNF-α) and nerve growth factor (NGF) with the degree of brain edema and prognosis after acute cerebral hemorrhage. Methods A total of 200 patients with acute cerebral hemorrhage admitted in the Seventh Medical Center of PLA General Hospital from January 2014 to June 2018 were retrospectively selected as the study subjects. The patients were divided into mild edema group (n?=?68), moderate edema group (n?=?70) and severe edema group (n?=?62) according to the volume of brain edema. The serum level of TNF-α and NGF was detected and compared at different time points in the three groups. According to the prognosis, patients were divided into survival group (n?=?172) and death group (n?=?8). Pearson correlation was used to analyze the correlation between serum TNF-α, NGF level and the severity of brain edema, and the influencing factor of prognosis was analyzed by Logistic regression models. Results Compared with the contents of TNF - α and NGF at different time points, the contents of TNF - α and NGF at different time points in the three groups were different (P?