张银善??赵文彬??张敏??赵志英

[摘要] 目的 對高血压脑出血患者急性期血液中肿瘤坏死因子-α（TNF-α）、白细胞介素-1（IL-1β）、促肾上腺皮质激素（ACTH）以及皮质醇（GC）的含量进行测定并对测定意义进行分析与探讨。 方法 选取高血压脑出血急性期患者45例作为研究组，选取健康体检者45例作为对照组，分别采取两组患者早上7～8时与晚上23～24时的外周血，利用酶联免疫吸附方法对其中TNF-α、IL-1β、ACTH以及GC含量进行测定，分析测定意义。 结果 研究组早间血液标本中TNF-α、IL-1β、ACTH与GC含量均明显高于对照组；研究组早间血液标本中TNF-α、IL-1β、ACTH与GC含量均低明显低于晚间，以上数据皆存在统计学意义（P<0.05）。经相关分析得出，TNF-α与ACTH、GC含量变化呈正相关；IL-1β与ACTH、GC含量变化也呈正相关。 结论 TNF-α与ACTH、GC、IL-1β与ACTH、GC间有相互作用机制存在，形成神经内分泌与免疫调节的网络，对脑出血急性期的应激反应有所参与。对其间相互作用进行深入细致的研究，可对脑血管病的病理机制了解进行帮助。

[关键词] 高血压脑出血；肿瘤坏死因子-α；白细胞介素-1；促肾上腺皮质激素；皮质醇

[中图分类号] R743.34 [文献标识码] A [文章编号] 2095-0616（2017）11-227-03

Significance of content detection of TNF-α，IL-1β，ACTH and GC in blood of patients with hypertensive cerebral hemorrhage in acute stage

ZHANG Yinshan ZHAO Wenbin ZHANG Min ZHAO Zhiying

Beijing Red Cross 999 Emergency Rescue Center，Beijing 100192，China

[Abstract] Objective To detect contents of tumor necrosis factor-α（TNF-α）， interleukin-1（IL-1β）， adrenocorticotropic hormone（ACTH） and cortisol（GC） in blood of patients with hypertensive cerebral hemorrhage in acute stage and to analyze and explore the significance of detection. Methods 45 patients with cerebral hemorrhage in acute stage were selected as the study group.45 healthy cases were selected as the control group.Peripheral blood of patients in two groups were respectively collected at 7am to 8am and at 23pm to 24pm.Contents of TNF-α，IL-1β，ACTH and GC were detected by enzyme-linked immunosorbent assay. Results Contents of TNF-α，IL-1β，ACTH and GC in the blood samples of morning in the study group were all significantly higher than those in the control group.Contents of TNF-α，IL-1β，ACTH and GC in blood samples of morning were significantly lower than those of evening.All above data were statistically significant （P<0.05）.The correlation analysis showed that TNF-α was positively correlated with ACTH and GC contents.IL-1β was also positively correlated with changes of ACTH and GC contents. Conclusion There is an interaction mechanism between TNF-α and ACTH and GC as well as between IL-1β and ACTH and GC.They form a network of neuroendocrine and immunoregulation which is involved in the stress response of cerebral hemorrhage in acute stage.The in-depth study of the interactions between them can help to understand the pathogenesis of cerebrovascular disease.

[Key words] Hypertensive cerebral hemorrhage；Tumor necrosis factor-α；Interleukin-1；Adrenocorticotropic hormone；cortisol

目前，有许多与急性脑血管病中细胞因子变化与内分泌激素变化相关的研究报道，但鲜少出现研究两者之间相互关系与作用机制的报道[1-3]。由此，本次研究选取高血压脑出血急性期患者45例作为研究组，选取健康体检者45例作为对照组，分别测定两组患者血压中TNF-α、IL-1β、ACTH以及GC含量，以对此种病症患者内分泌与免疫之间的调节机制进行研究与探讨，现报道如下。

1 资料与方法

1.1 一般资料

选取高血压脑出血急性期患者45例作为研究组，选取健康体检者45例作为对照组。研究组中有男26例，女19例，年龄45～75岁，平均（60.8±3.6）岁，研究组患者具体纳入标准为患者经脑CT检查证实其病症诊断结果与1994年全国第四届脑血管病学术会议所修订的相关诊断标准符合，且患者脑内血肿体积为35.7～76.5mL；……