Changes of serum TNF-α levels in hemorrhagic transformation of acute cerebral infarction and analysis of the risk factors

Objective To investigate the dynamic changes of serum tumor necrosis factor-α (TNF-α) levels in patients with acute cerebral infarction especially with hemorrhagic transformation (HT),and investigate the effect of TNF-α on the pathogenesis of hemorrhagic transformation of acute cerebral infarction,and the clinical feature and the risk factors of hemorrhagic transformation of cerebral infarction.Methods One hundred and ninety-eight patients with cerebral infarction and 45 normal controls were included into this study from February 2011 to June 2012.There were 48 patients with hemorrhagic transformation of acute cerebral infarction,and 150 cases of purely cerebral infarction.Radioimmunoassay was used to continuously detect the serum levels of TNF-α on 1 st,4 th,7 th and 10 th day in all patients and normal controls.Logistic regression analysis was used to find out the risk factors of hemorrhagic transformation of cerebral infarction.Results Serum levels of TNF-α in acute cerebral infarction patients with hemorrhagic transformation began to rise on the first day of onset (P ＜ O.05),and reached peak levels on the fourth day (P ＜ 0.01),and then decreased gradually,but was still high-er than that in normal control group and purely cerebral infarction group on the tenth day (P ＜ 0.05) As the focal infarction size and the hematoma presented more larger,the serum TNF-α level would be more higher.Compared with other groups,the differences were significant (P ＜ 0.05 or ＜ 0.01).Cerebral embolism,cerebral cortex infarction,massive cerebral infarction,hyperglycemia were the independent risk factors for the hemorrhagic transformation of cerebral infarction.The thrombolytic therapy could increase the risk of hemorrhagic transformation,but anticoagulation therapy was not related to the hemorrhagic transformation.Conclusions The dynamic change of serum TNF-α levels is correlated with the occurrence and development of cerebral infarction especially with hemorrhagic transformation (HT),the serum TNF-α level in hemorrhagic transformation of cerebral infarction is higher and the elevated levels of TNF-α keep more longer,the brain damage is more serious.Cerebral embolism,cerebral cortex infarction,massive cerebral infarction,hyperglycemia are correlated with HT.Thrombolytic therapy is correlated with the occurrence of hemorrhagic transformation of cerebral infarction. Key words: Hemorrhagic transformation of cerebral infarction;  Tumor necrosis factor-α;  Risk factors;  Massive cerebral infarction;  Cerebral embolism