目的探讨正五聚蛋白-3（PTX-3）在蛛网膜下腔出血（SAH）后脑血管痉挛（CVS）发生过程中的作用机制。方法分别检测SAH患者和健康对照组外周血白细胞（WBC）、中性粒细胞百分比（NE％）和脑脊液（CSF）中WBC、PTX-3水平。结果 SAH患者外周血 WBC、NE％和CSF WBC、多个核细胞数均显著高于健康对照组（P＜0．01，P＜0．05）；并且，血清和CSF PTX-3水平也显著高于健康对照组（P＜0．01，P＜0．05）。SAH患者痉挛组WBC、NE％与未痉挛组相比，差异无统计学意义（P＞0．05），与之相反，SAH患者痉挛组CSF WBC、多个核细胞数显著高于未痉挛组，差异具有统计学意义（P＜0．05），值得关注的是，血清PTX-3水平与未痉挛组相比，差异无统计意义（P＞0．05），而CSF PTX-3水平显著高于未痉挛组（P＜0．01）。SAH患者痉挛组WBC、NE％和CSF WBC、多个核细胞数在1、2、3、5、7 d均显著高于健康对照组，差异具有统计学意义（P＜0．01）；并且，SAH患者痉挛组血清和CSF PTX-3水平在1、2、3、5、7 d均显著高于健康对照组，差异具有统计学意义（P＜0．01）。结论 SAH患者机体存在高强度的全身和局部炎症反应。局部炎症反应与CVS的发生密切相关。CSF高水平PTX-3可能通过诱导局部炎症反应而介导CVS的发生。CVS的发生依赖于患者机体高强度炎症反应的持续存在，而PTX-3可能是介导高强度炎症反应持续存在的关键效应分子。%Objective To investigate the mechanism of pentraxin-3 (PTX-3) in pathogenesis of cerebral vaso-spasm (CVS) after subarachnoid hemorrhage (SAH) .Methods The levels of white blood cell (WBC) ,neutrophil percentage (NE% ) and PTX-3 in cerebrospinal fluid (CSF) and peripheral blood from SAH patients and healthy subjects were detected respectively .Results WBC and NE% levels of peripheral blood and CSF in SAH group were significantly higher than healthy controls (P<0 .01 ,P<0 .05) .Serum and CSF PTX-3 levels in SAH group were significantly higher than healthy controls (P<0 .01 ,P<0 .05) .CSF levels of WBC ,NE% and PTX-3 in SAH pa-tients with CVS were higher than SAH patients without CVS (P<0 .05) ,but the difference of serum PTX-3 level was not significant (P> 0 .05) .On 1 ,2 ,3 ,5 and 7 days after SAH ,CSF and peripheral blood levels of WBC , NE% and PTX-3 in patients with CVS were significantly higher than healthy controls (P<0 .01) .Conclusion The pathogenesis of CVS might be with high level systemic and local inflammatory response in SAH patients .High level of PTX-3 in CSF might mediate the onset of CVS by inducing local inflammatory reaction .The occurrence of CVS could be dependent on the persistence of highly intensive inflammatory response ,of which PTX-3 might be the key mediating molecule .
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