Kraus J, Gerriets T, Leis S, Stolz E, Oschmann P, Heckmann J G
Paracelsus Private Medical University and Salzburger Landesklinken, Christian-Doppler-Klinik, Department of Neurology, Ignaz-Harrer-Strasse Salzburg, Austria.
Acta Neurol Scand. 2007 Jul;116(1):49-55. doi: 10.1111/j.1600-0404.2006.00790.x.
In a pilot study we found a correlation of the clinical outcome with adhesion molecule (AM) concentrations in ventricular cerebrospinal fluid (CSF) but not in serum in patients with intracerebral haemorrhage. We now determined the time course of AM concentration in CSF and serum after basal ganglia haemorrhage (BGH) in order to further uncover pathogenetic mechanisms.
We included 11 patients with acute BGH and ventricular tamponade in which an extraventricular drainage had been applied to treat ventricular ballonade. Paired CSF and serum samples were obtained within 8 h after onset of BGH, as well as on the consecutive days 2, 4, 6, and 8, respectively. The concentrations of soluble ICAM-1 (sICAM-1) and VCAM-1 (sVCAM-1) in CSF and serum were measured by enzyme-linked immunosorbent assay. Moreover, we determined blood volume and perifocal oedema by a semi-automated planimetry technique from initial cranial computed tomography scans.
sICAM-1 and sVCAM-1 levels in CSF were highest within the first hours after onset of BGH, then decreased significantly (P < 0.005 and <0.05, respectively) on day 2 and slightly increased thereafter. Furthermore, BGH volume was significantly correlated with the concentrations of sICAM-1 (r = 0.63, P < 0.05) and sVCAM-1 (r = 0.66, P < 0.05) in ventricular CSF but not in serum.
Our results might indicate that the local inflammatory reaction is pronounced early after onset of BGH and appears to be restricted to the central nervous system. Moreover, AM concentrations measured early after BGH onset correlated stronger with radiological and clinical data than follow-up measurements.
在一项初步研究中，我们发现脑出血患者脑室脑脊液（CSF）中黏附分子（AM）浓度与临床结局相关，而血清中无此关联。我们现在测定基底节区脑出血（BGH）后脑脊液和血清中AM浓度的时间进程，以进一步揭示发病机制。
我们纳入了11例急性BGH并伴有脑室受压的患者，这些患者接受了脑室外引流以治疗脑室膨胀。在BGH发病后8小时内以及随后的第2、4、6和8天分别采集配对的脑脊液和血清样本。采用酶联免疫吸附测定法测量脑脊液和血清中可溶性细胞间黏附分子-1（sICAM-1）和血管细胞黏附分子-1（sVCAM-1）的浓度。此外，我们通过半自动平面测量技术从最初的头颅计算机断层扫描中测定出血量和灶周水肿。
脑脊液中sICAM-1和sVCAM-1水平在BGH发病后的最初几小时内最高，然后在第2天显著下降（分别为P < 0.005和<0.05），此后略有上升。此外，BGH出血量与脑室脑脊液中sICAM-1（r = 0.63，P < 0.05）和sVCAM-1（r = 0.66，P < 0.05）的浓度显著相关，而与血清中无关。
我们的结果可能表明，BGH发病后早期局部炎症反应明显，且似乎局限于中枢神经系统。此外，BGH发病后早期测量的AM浓度与影像学和临床数据的相关性比随访测量更强。
