摘要
目的脑血管痉挛(cerebral vasospasm,CVS)作为动脉瘤性蛛网膜下腔出血(aneurysmal subarachnoid hemor-rhage,aSAH)后的主要并发症,其发病机制未予完全阐明。文中探讨aSAH患者不同时期血浆内皮素-1(endothelin-1,ET-1)和NO的含量变化与CVS的发生关系。方法选取动脉瘤性蛛网膜下腔出血患者26例,在病程的24 h内、第3天、第7天及第14天抽取外周静脉血采用放射免疫法及高效液相色谱法分别测定血浆ET-1和NO含量,另选取同时期同年龄段健康人6名进行对比研究。结果 aSAH患者在发病2周内各个时间段血浆ET-1含量均高于对照组(P<0.05),同时CVS组血浆ET-1含量明显高于未发生CVS组(P<0.05)。aSAH患者在病程的24 h内、第3天、第7天血浆NO含量均低于对照组(P<0.05),同时CVS组血浆NO含量在第3天及第7天高于未发生CVS组(P<0.05),2周左右NO值恢复正常。结论 aSAH后CVS的发生与血浆ET-1和NO含量变化呈明显相关性,两者在体内的动态平衡遭到破坏时,有可能导致CVS的发生,同时监测其含量变化有助于CVS的早期防治。
Objective Cerebral vasospasm （CVS） is the primary complication following aneurysmal subarachnoid hemorrhage （ aSAH）, and its mechanism is not yet clear. This study aimed to investigate the relationship of post-aSAH CVS with the concentrations of endothelin-1 （ET-1） and nitric oxide （NO） in the plasma at different stages of the disease. Methods We collected peripheral venous blood from 26 aSAH patients within 1 d, 3 d, 7 d and 14 d after the ictus, and measured the concentrations of ET-1 and NO in the plasma by radio-immunological analysis and high-performance liquid chromatography. Six age-matched healthy subjects were enlis- ted as controls. Results Within 14 d after the ictus, the ET-1 concentration was significantly higher in the aSAH patients than in the healthy subjects （P 〈 0.05）, and so was it in those with CVS than in those without （P 〈 0.05）. The NO concentration was signifi- cantly lower in the aSAH patients than in the healthy controls within the 1 d, 3 d and 7 d after the ictus （P 〈 0.05）, markedly higher in those with CVS than in those without （P 〈 0.05）, and returned to normal at 14 d. Conclusion The incidence of post-aSAH CVS was significantly correlated with the concentrations of ET-1 and NO in the plasma, and most likely with the imbalance of the two fac- tors. Monitoring the changes in their concentrations may help the prevention and treatment of CVS.
出处
《医学研究生学报》
CAS
北大核心
2012年第12期1257-1260,共4页
Journal of Medical Postgraduates
基金
江苏省医学重点学科基金(x4200722)
江苏省中医药管理局课题(LZ09041)
