作　　者： (吕尧）; (郑君）; (戴伟民）; (揭园庆）; (余国峰）; (范晓峰）; (吴安）;

机构地区： 衢州市人民医院神经外科,浙江省衢州324000

出　　处： 《中国基层医药》 2017年第19期2937-2940,I0003,共5页

摘　　要： 目的探讨颅内动脉瘤患者动脉瘤组织中肿瘤坏死因子仅（TNF-α）、白细胞介素-6（IL-6）的表达水平与血清铁蛋白浓度的变化及其临床意义。方法选择2014年1月至2015年1月衢州市人民医院收治的经开颅神经外科手术切除颅内动脉瘤的患者22例作为观察组，另选同期该院收治的头颅外伤患者16例作为对照组，动脉瘤标本和正常脑血管标本均为手术中切除，采用HE染色法和免疫组织化学染色法对标本进行染色，分别观察观察组和对照组标本中的炎性细胞浸润情况和TNF—α／IL-6的表达水平，分析组织内TNF-α和IL-6的表达水平；并在入院时、手术后3d和7d采集两组患者静脉血，采用电化学发光免疫分析法（ECLIA）检测血清铁蛋白的含量。结果观察组免疫组织化学染色后可见大量阳性细胞，TNF-α[（0．194±0．074）比（0．135±0．047），t=2．799]和IL-6[（0．152±0．057）比（0．103±0．028），t=3．494]的表达水平均显著高于对照组（P=0．008，0．001）；观察组患者血清铁蛋白在手术后3d[（232．25±105．26）ng／mL比（169．51±66．24）ng／mL，t=2．097]和7d[（263．39±114．73）ng／mL比（166．57±73．71）ng／mL，t=2．955]时显著高于对照组（P=0．043，0．005）。且观察组患者血清铁蛋白不同时间之间差异也有统计学意义（F=8．625，P=0，003）。结论TNF-α和IL-6在颅内动脉瘤中均有高水平表达，它们可能是颅内动脉瘤形成的重要因素之一，对于颅内动脉瘤患者的早期预防和药物治疗提供了重要参考依据；血清铁蛋白与颅内动脉瘤破裂出血有关，或能用于判断预后指导合理治疗，值得进一步研究确认。 Objective To investigate the expression levels of tumor necrosis factor alpha （ TNF - α）, interleukin- 6（IL -6） and the change of serum ferritin in patients with intracranial aneurysm and its clinical significance. Methods 22 patients with intracranial aneurysm and 16 cases of traumatic brain injury who recevied operation in Department of Neurosurgery in Quzhou People＇s Hospital from Jan. 2014 to Jan. 2015 were enrolled as observation group and control group. The intracranial aneurysm tissues and normal cerebral vascular tissues were collected respectively to detect the situation of inflammatory cell infiltration, and the expression of TNF - α and IL - 6 was detected by HE staining and immunohistochemical staining. The serum was collected on hospitalized, postoperative 3 days and postoperative 7 days to detect serum ferritin. Results The positive cells were observed in the observation group after immunohistochemical staining, in which the expression levels of TNF - α [ （0.194±0.074） vs. （0.135 ±0.047） ,t = 2. 799 ] and IL - 6 [ （0. 152± 0. 057 ） vs. （ 0. 103±0. 028 ）, t = 3. 4941 were significantly higher than those in the control group （P=0. 008,0. 001 ）. The serum ferritin level in the observation group was significantly higher than that in the control group at postoperative 3d[ （232.25 ± 105.26）ng/mL vs. （169.51 ± 66.24）ng/mL, t = 2. 097 ] and postoperative 7d[ （263.39 ± 114.73 ） ng,/mL vs. （ 166.57 ±73.71 ） ng/mL, t = 2. 9551 （ P = 0. 043, 0. 005 ）. The difference of serum ferrltin on different day in the observation group also was statistically significant（ F = 8.625 ,P=0. 003 ）. Conclusion The expression levels of TNF-α and IL- 6 in intracranial aneurysms were high, which may be one of the important factors in the formation of intraeranial aneurysms, and it provides an important reference of early prevention and drug treatment for patients with intraeranial aneurysm. The serum ferritin is related to the rupture and hemorrhage of intracranial

关 键 词： 颅内动脉瘤 肿瘤坏死因子 白细胞介素 血清铁蛋白