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目的动态观察急性脑血管病患者血浆肿瘤坏死因子－α水平的变化，探讨其临床意义。方法采用双抗体夹心（ＥＬＩＳＡ）法测定了７４例急性脑血管病（ＡＣＶＤ）患者及４２例正常对照者血浆肿瘤坏死因子－α（ＴＮＦ－α）水平。结果急性期ＡＣＶＤ患者血浆ＴＮＦ－α水平显著高于正常组Ｐ＜０．０１，恢复期ＴＮＦ－α水平明显下降，但仍显著高于正常对照组Ｐ＜０．０１。动态观察结果显示发病后３ｄ血浆ＴＮＦ－α水平最高。随着病程的延长，ＴＮＦ－α水平呈下降趋势，但仍未恢复至正常水平。结论急性脑血管病患者存在神经－炎症／免疫－内分泌功能紊乱，ＴＮＦ参与了ＡＣＶＤ的炎症／免疫反应发生发展过程。
Objective To observe the changes of plasma levels of tumor necrosis factor-α in patients with acute cerebrovascular disease and to investigate its clinical significance. Methods Tumor necrosis factor-α (TNF-α) levels were measured in 74 patients with acute cerebrovascular disease (ACVD) and 42 normal controls by double-antibody sandwich ELISA. Results The plasma level of TNF-α in acute phase of ACVD patients was significantly higher than that of the normal group (P <0.01), and the level of TNF-α in convalescent phase was significantly decreased, but still significantly higher than that of the normal control group (P <0.01). Dynamic observation results showed that the plasma TNF-α level was the highest at the third day after onset. As the course of the disease prolonged, TNF-α level showed a downward trend, but still not returned to normal levels. Conclusion There are neuro-inflammatory / immune-endocrine disorders in patients with acute cerebrovascular disease. TNF participates in the development of inflammatory and immune responses in ACVD.