Clinical Investigation Of Tumor Necrosis Factor-alpha On Acute Cerebrovascular Diseases

Objective: the study has measured the dynamic changes of tumor necrosis factor -alpha (TNF- α ) in serum of all patients and cerebrospinal fluid(CSF) of a part of patients who have acute cerebrovascular diseases (ACVD) by using enzyme-linked immuno-sorbent assay. Moreover the serum changes of TNF- α were comparied with clinical patients' conditions and screenages to investigate the role of TNF-α on ACVD and the clinical significance. Methods: 95 patients were Choosed and divided into cerebral hemorrhage group (20 subjects) , cerebral infarction group (60 subjects) and subarachnoid hemorrhage group(SAH) (15 subjects) . Healthy people comparable with age and sex were selected as the serum control (20 subjects) and CSF control (10 subjects). After episode, on the first day, third day,seventh day and fourteenth day respectively elbow venous blood were collected in the morning. For SAH, at the same time CSFs were got by the punching technology of vertebrae lumbales. All specimen were Stored at -80 ℃ to measure. We observed the variance of TNF- α in cerebral infarction group in relation to infarction volume, neurologic impairment score, and patients' conditions deterioration. We also compared the difference of TNF-α between serum and CSF for SAH. Furthermore we compared the serum TNF- α difference among three ACVD. The Wellscan MK3 auto-analysisenzyme marking meter made by Labsystems Dragon company in Finland was used to determinate the content of TNF- α in serum and CSF. Statistics analysis software SPSS and SAS was applied to deal with the data. Excel2000 was employed to make diagrams. Results: (1)The serum dynamic changes of TNF- α are significant among three diseases. The serum TNF- α get to peak on the third day for the groups of cerebral infarction and cerebral hemorrhage. While the peak time of TNF-α is on the first day for the group of SAH. (2)The serum TNF- α level of patients who have cerebral infarction correlates with the infarctional area, the degree of neurologic impairment and the deterioration of the state of patients. (3)For SAH patients ,the TNF- α of CSF is taller than that of serum on the first day, third day, seventh day, and drops to the control level and has no differences with that of serum on the fourteen day. Conclusion: (1) For patients of cerebral infarction, the dynamic observation of serum TNF- α might clinically provide some bases for predicting the infarction area, neurologic impairment and deterioration. (2) For early cerebral infarction patients, if brain CT can not find any significant lesion, the obvious improvement of serum TNF- α is helpful for clinical diagnosis and treatment. (3) The CSF TNF- α of SAH is taller than that in the serum. This shows neurological tissues in brain can produce TNF- α. Continuously advancing TNF-α in CSF may be correlated with cerebrovascular spasm after SAH. (4)TNF- α involves in the inflammatory progress of ACVD. Early inhibiting its production and anti-inflammatory strategy may have latent clinical value.