一氧化氮和一氧化氮合酶在急性大面积脑梗死患者中的表达  

Expression of nitric oxide and nitric oxide synthase in patients with acute massive cerebral infarc- tion

作　　者：陈春美[1] 杨卫忠[1] 王锐[1] 石松生[1] 王春华[1] 

机构地区：[1]福建医科大学附属协和医院神经外科福建省神经外科研究所,福州350001

出　　处：《中华实验外科杂志》2011年第4期586-588,共3页Chinese Journal of Experimental Surgery

基　　金：基金项目：福建省教育厅科技计划资助项目（JA04200）

摘　　要：目的观察一氧化氮（NO）和一氧化氮合酶（NOS）在急性大面积脑梗死患者去骨瓣术后的表达。方法急性大面积脑梗死患者16例（脑梗死组），均采用全麻开颅去骨瓣减压手术，手术中切除部分梗死额叶组织；以6例重型颅脑外伤行正常额叶组织内减压为对照组。2组均采用透视电镜观察额叶细胞超微结构，检测NO含量和NOS活性，Western blot法分析内皮型NOS（eNOS）、神经元型NOS（nNOS）和诱导型NOS（iNOS）蛋白表达特点。结果本组病例16例脑梗死患者术后神志不同程度改善，无死亡病例；NO含量在脑梗死组和对照组分别为85．4U／m1和36．2U／甜，NOS活性在脑梗死组和对照组分别为63．2μmol／L和37．2μmol／L，差异均有统计学意义（P〈0．05）；与对照组比较，eNOS、nNOS和iNOS在脑梗死组中表达均明显升高，尤其是iNOS表达相对值为0．76，远远超过对照组未见表达，差异均有统计学意义（P〈0．05）。结论去骨瓣减压是治疗急性大面积脑梗死的有效治疗手段，能够降低患者死亡率；NO和NOS参与并影响了大面积脑梗死后复杂的病理生理过程，去骨瓣减压后局部脑血供得到有效改善，NOS活性减低，尤其iNOS活性明显减少，合成NO减少，神经毒性减低，临床症状好转。Objective To study the expression of nitric oxide （NO） and nitric oxide synthase （NOS） in patients with acute massive cerebral infarction. Methods Sixteen patients （cerebral infarction group） with acute massive cerebral infarction were subjected to craniotomy decompression craniectomy un- der the anesthesia, and part of the infarct frontal lobe was removed. The normal frontal lobe from 6 cases of severe brain injury receiving the intracranial decompression served as control group. The ultrastructures of frontal lobe cells were observed under the electron microscopy. Serum NO content and NOS activity were measured. The protein expression patterns of eNOS, nNOS and iNOS were analyzed by Western blotting. Results The consciousness in 16 patients with acute massive cerebral infarction was improved after opera- tion to varying degrees, and there were no deaths. The NO contents and NOS activities in cerebral infarc- tion group and control groups were 85.4 and 36. 2 U/ml, and 63.2 and 37.2 ~Lmol/L （ all P 〈 0. 05）. As compared with control group, the expression of eNOS, nNOS and iNOS in cerebral infarction group was sig- nificantly increased, especially the expression of iNOS （ all P 〈 0.05）. Conclusion Craniotomy decom- pression craniectomy was the effective treatment to cure the acute massive cerebral infarction. It could re- duce mortality. NO and NOS participated in and influenced the complex pathophysiologlcal process of mas- sive cerebral infarction. After craniotomy decompression craniectomy the regional cerebral blood was effec- tively improved, and NOS activity, especially iNOS, and the synthesis of NO were reduced, resulting in the reduction to neurotoxicity and improvement in clinical symptoms.

关 键 词：脑梗死 一氧化氮合酶 去骨瓣减压 

分 类 号：R743.33[医药卫生—神经病学与精神病学]