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目的探讨蛛网膜下腔出血后血清补体变化。方法对２１例蛛网膜下腔出血（ＳＡＨ）患者及１４例高血压脑出血（ＣＨ）患者进行血清总补体溶血活性（ＣＨ５０）及补体成分Ｃ３、Ｃ４的动态检测，观察其值在ＳＡＨ病程中的变化情况。结果（１）ＳＡＨ的出血量与Ｃ３、Ｃ４值呈负相关（Ｐ＜０．０１），与ＣＨ５０值无相关；（２）Ｃ３、Ｃ４值与脑血管痉挛（ＣＶＳ）有对应性变化，即有ＣＶＳ的患者Ｃ３值在０．８ｇ／Ｌ以下，Ｃ４值在０．４ｇ／Ｌ以下；无ＣＶＳ的患者病后Ｃ３值在０．９ｇ／Ｌ以上，Ｃ４值在０．４ｇ／Ｌ以上，且在ＣＶＳ发生以前Ｃ３、Ｃ４值明显下降；（３）Ｃ４值呈急剧下降且最低值在０．２ｇ／Ｌ以下的ＣＶＳ患者预后极差。结论在ＳＡＨ后的病程中补体成分Ｃ３、Ｃ４值出现有意义的变化，ＣＨ５０值无明显变化；ＳＡＨ后慢性脑血管痉挛（ＣＣＶＳ）发生前Ｃ３、Ｃ４值明显下降，Ｃ３、Ｃ４值可做为预测ＣＣＶＳ发生的指标；在ＣＣＶＳ发生之前Ｃ４值呈急剧下降，在０．２ｇ／Ｌ以下者提示预后不良。
Objective To investigate the changes of serum complement after subarachnoid hemorrhage. Methods Twenty-one patients with subarachnoid hemorrhage (SAH) and 14 patients with hypertensive intracerebral hemorrhage (CH) were enrolled in this study. Total complement hemolysis (CH50) and complement components C3 and C4 were detected dynamically in SAH Changes in the situation. Results (1) The bleeding volume of SAH was negatively correlated with C3 and C4 (P <0.01), but not with CH50. (2) There was a corresponding change of C3 and C4 values with CVS, Patients with CVS had a C3 value below 0.8 g / L and a C4 value below 0.4 g / L; patients without CVS had a C3 value above 0.9 g / L and a C4 value above 0.4 g / L, And the values of C3 and C4 decreased significantly before the occurrence of CVS. (3) The CVS patients with a sharp decline in C4 value and the lowest value below 0.2g / L had very poor prognosis. Conclusions There is a significant change in the values of C3 and C4 in the course of SAH after CHH but no significant change in CH50. The values of C3 and C4 before CCVS decrease significantly after SAH, while the values of C3 and C4 can be used as Predict the occurrence of CCVS indicators; C4 values before the occurrence of CCVS showed a sharp decline in less than 0.2g / L prompted a poor prognosis.