动脉瘤性蛛网膜下腔出血患者血液NF-κB与sICAM-1含量变化的临床意义

摘要

目的：探讨动脉瘤性蛛网膜下腔出血(SAH)患者血液核因子-剀B (NF-κB)与可溶性细胞间黏附分子-1(sICAM-1)含量变化的临床意义。方法选择2012年2月~2014年2月收治的30例动脉瘤性SAH患者，在48 h内、第7天、1个月时分别抽取外周静脉血，观察血液NF-κB与sICAM-1含量的变化，并用TCD检测大脑中动脉血流速度。结果SAH组患者手术前后NF-κB与sICAM-1含量均明显高于对照组，差异有统计学意义(P<0.05)。脑血管痉挛患者病情越重，血液NF-κB与sICAM-1含量越高；与轻度脑血管痉挛患者比较，中、重度脑血管痉挛患者血液NF-κB与sICAM-1含量明显升高，差异有统计学意义(P<0.05)；与中度脑血管痉挛患者比较，重度脑血管痉挛患者血液NF-κB与sICAM-1含量明显升高，差异有统计学意义(P<0.05)。结论 NF-κB的高表达主要发生在脑血管痉挛的早期；早期监测NF-κB可以很好地预防和控制脑血管痉挛的发生、发展；sICAM-1高表达主要发生在脑血管痉挛的中期，其含量与病情演变、脑血管痉挛有关。%Objective To investigate clinical significance on content changes of blood NF-κB and sICAM-1 of patients with aneurysmal subarachnoid hemorrhage (SAH). Methods 30 patients with aneurysmal SAH treated in our hospital from February 2012 to February 2014 were selected.Peripheral venous blood of patients were drawn within 48-hour,7-day,1-month,content changes of blood NF-κB and sICAM-1 of patients were observed.Middle cerebral artery blood flow velocity of patient was detected by TCD. Results Content of blood NF-κB and sICAM-1 before and after opera-tion in SAH group was obviously higher than that in control group respectively,with statistical difference (P<0.05).The heavier condition of cerebral vasospasm patients,the higher content of blood NF-κB and sICAM-1.Compared with pa-tients with mild cerebral vasospasm,content of blood NF-κB and sICAM-1 in patients with moderate and severe cere-bral vasospasm was increased significantly respectively,with statistical difference (P<0.05).Compared with patients with moderate cerebral vasospasm,content of blood NF-κB and sICAM-1 in patients with severe cerebral vasospasm was in-creased significantly respectively,with statistical difference(P<0.05). Conclusion The high expression of NF-κB mainly occur in the early stage of cerebral vasospasm.The early monitoring of NF-κB can effectively prevent and control the occurrence and development of cerebral vasospasm.The high expression of sICAM-1 occurred mainly in the middle stage of cerebral vasospasm,its content is related to illness evolution and cerebral vasospasm.