脑血管病时下丘脑──垂体──肾上腺皮质轴的功能改变及临床意义  

Functional Changes of Hypothalamus-pituitary-adrenocortical Axis Caused by Cerebrovascular Disease(CVD)and Its Clinical Significance

作　　者：张红宇[1] 张茂林[1] 曹桂华[1] 段建平[1] 王颖慧[1] 

机构地区：[1]包头医学院一附院神经内科

出　　处：《包头医学院学报》1996年第2期35-38,共4页Journal of Baotou Medical College

摘　　要：应用放射免疫分析法对１７２例脑血管病（ＣＶＤ）患者（脑出血６８例、脑梗寒１０４例）的血清促肾上腺皮质激素（ＡＣＴＨ）和皮质醇（Ｃｏｒ）含量进行了测定，并对不同病程，不同病变部位ＣＶＤ时Ｈ／Ｐ／Ａ机能的改变进行了观察。急性期ＣＶＤ患者血清ＡＣＴＨ和Ｃｏｒ含量水平明显高于对照组，差异均有统计学意义（Ｐ＜０．０５，Ｐ＜０．０１），尤以脑出血者为显著。恢复期时含量水平明显下降，与对照组比较，差异仍有统计学意义（Ｐ＜０．０５）。提示随着病程延长，病症好转，Ｈ／Ｐ／Ａ机能紊乱具有可逆性。不同病变部位ＣＶＤ时，丘脑病变血清ＡＣＴＨ和Ｃｏｒ含量最高，基底节区病变次之。提示ＣＶＤ时Ｈ／Ｐ／Ａ机能呈应激性分泌增强，与中线结构移位、下丘脑、垂体及第三脑室壁受压迫损害相关。he level of ACTH and cortisol content in the sera of 172 cases of cerebrovascular dis-ease 68 cases of cerebral hemorrhage,104 cases of cerebral infarction) was determined withanalvtical method of radio-immunity,and the functional changes of H/P/A of the patientswith different pathological-change parts and in different course of disease were also keptunder observation.It is shown that the level of ACTH nd cortisol content in the serum of CVD patients in acute phase is significantly higher than that in the serum of the controlgroup,which is of statistical significance(P<0.05,P<0.01)and remarkable for those withcerebral hemorrhage;the level of ACTH and cortisol content in the serum of CVD patientsfalls in the recovery phase,which,compared with the corittol group,is also significant instatistics(P<0.05).It is suggested that,with prolonging of the course of disease and im-provement of the condition,the disorder of H/P/A function represents reversibility;of dif-ferent parts of pathological changes with CVD,serum ACTH and cortisol content of the pa-tients with thalamus pathological changes is highest and comes next that of those with nucleibasales pathological changes; irritable secreting function of H/P/A of those with CVDchances,which is related to displacelnent of the middle line structure and to the damage ofhypothalamus,pituitary and the walls of the third ventricle.

关 键 词：脑血管病 病变部位 H/P/A 病理 

分 类 号：R743.02[医药卫生—神经病学与精神病学]