脑出血患者血清血小板源性生长因子的动态变化及其临床意义

目的: 探讨血清血小板源性生长因子(PDGF)含量对脑出血的诊断以及病情程度评估的临床意义。方法: 收集本院2009年12月至2010年12月神经内科住院的内囊处脑出血患者78例,另选32例健康体检者作为对照,采用酶联免疫吸附双抗体夹心法(ELISA)检测急性脑出血患者发病后 48 h 内、第4天和第8天血清PDGF水平,并设立正常对照;脑出血患者应用NIHSS评测法对神经功能缺损程度评分;患者入院 3 d 内进行头颅CT检查,按照血肿体积分为少量出血组(血肿体积<20 mL)、中量出血组(血肿体积介于20～40 mL 之间)、大量出血组(血肿体积>40 mL)对照其血清PDGF水平的动态变化。流式细胞仪检测血小板PDGF的表达变化。结果: 脑出血患者<48 h 时的血清PDGF含量明显高于正常对照组 (P<0.01),并一直持续到第4天,第8天血清PDGF含量开始下降(P<0.05),流式细胞仪检测血小板PDGF的表达变化也显示了相似的变化。脑出血患者血清PDGF蛋白水平与NIHSS评分呈正相关(r=0.62,P<0.01)。不同脑出血体积患者之间血清PDGF的含量存在统计学差异,随血肿体积的增大其水平也相应的升高(P<0.05)。结论: 血清PDGF含量的变化可以作为内囊处急性脑出血患者的早期诊断指标,同时血清PDGF水平的高低可以反映出患者出血的严重程度。

Correlation between serum concentration of platelet derived growth factor and intracerebral hemorrhage

AIM: To observe the dynamic changes of serum levels of platelet derived growth factor (PDGF) in the patients with intracerebral hemorrhage.METHODS: A total of 78 patients with intracerebral haemorrhagia (internal capsule) were enrolled in this study. The serum PDGF was determined by enzyme-iineked immunosorbent assay (ELISA). The degree of neural function defect was analysed by NIHSS appraise. The perihematomal edema volumes was evalulated by CT. The expression of PDGF in platelets was detected by flow cytometric analysis.RESULTS: The serum concentration of PDGF was significantly higher than that in control group (P<0.01). The PDGF level of intracerebral haemorrhagia group was increased remarkebly within 4 days. The expression of PDGF in platelets was also increased remarkebly as that in serum. The PDGF level was decreased remarkebly in the 8th day in intracerebral haemorrhagia group (P<0.05), and which was positively correlated with NIHSS appraise (r=0.62,P<0.01). The serum level of PDGF protein was positive associated with the value of hematoma (P<0.05).CONCLUSION: Increased PDGF level was found in the patients with intracerebral hemorrhage. The serum PDGF levels of patients with cerebral hemorrage may be used as a biomarker to reflect the degree of pathogenetic.