蛛网膜下隙出血后脑血管痉挛与血管内皮功能的相关性研究  

Relationship between vascular endothelium function and cerebral vasospasm after subarachnoid hemorrhage

作　　者：张学基[1] 张崇岳[1] 任刚[2] 

机构地区：[1]甘肃省中医院神经外科,兰州730050 [2]大连大学附属中山医院神经外科

出　　处：《中国医师进修杂志》2011年第17期10-12,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的研究蛛网膜下隙出血后不同时期血浆降钙素基因相关肽（CGRP）、内皮素（ET）-1的表达水平，以探讨蛛网膜下隙出血后CGRP、ET-1与脑血管痉挛发病机制的相关性。方法38例蛛网膜下隙出血患者根据有无脑血管痉挛分为脑血管痉挛组（31例）及非脑血管痉挛组（7例），采用放射免疫法测定蛛网膜下隙出血后不同时间段（1—3d、4—7d、14～21d）血浆CGRP、ET-1水平，并与20例健康体检者（健康对照组）进行比较。结果与健康对照组及非脑血管痉挛组比较，脑血管痉挛组蛛网膜下隙出血后血浆CGRP含量明显降低，特别是在4～7d时间段下降显著，差异有统计学意义（P〈0．05或〈0．01）；同时血浆ET-1含量明显升高，特别是在4～7d时间段显著升高，差异有统计学意义（P〈0．05或〈0．01）。脑血管痉挛组在蛛网膜下隙出血后1—3d出现2例，4～7d出现28例，14～21d出现1例。脑血管痉挛组中2例脑动脉瘤再破裂，1例因大面积脑梗死发生脑疝而死亡。6例在治疗过程中新发脑梗死病情加重，经治疗后好转，其他患者疗效满意。结论CGRP、ET-1参与了蛛网膜下隙出血的病理生理过程，血管内皮收缩／舒张功能紊乱与脑血管痉挛的关系密切。Objective To detect plasma concentrations of Calcitonin gene-related peptide （CGRP）,endothelin （ET）-1 at different periods after subarachnoid hemorrhage （SAH）,and probe the correlation of CGRP,ET-1 and the pathogenesis of cerebral vasospasm after SAH. nehods Plasma concentrations of CGRP,ET-1 were measured in patients who were diagnosed with SAH （38 cases） at different periods （1-3 d,4-7 d,14-21 d after SAH） by radio-immunity technique. According to the occurrence of cerebral vasospasm, these patients were separated into two groups： vasospasm group （31 cases ） and non-vasospasm group （7 cases）. Twenty healthy persons after physical examinations were allocated to be control group. Results Compared with control group and non-vasospasm group,the plasma concentration of CGRP in vasospasm group was obviously lower,especially in the 4-7 d time slot,and ET-1 was obviously higher, especially in the 4-7 d time slot. There were statistical differences among the three groups （P 〈 0.05 or 〈0.01）. Cerebral vasospasm occurred in 2 cases during 1-3 d,in 28 cases during 4-7 d and in 1 case during 14-21 d after SAI-I. Conclusions CGRP,ET-1 participate in the pathological process of SAH. The abnormality of vascular endothelial construction/diastolic function is correlated with delayed cerebral vasospasm.

关 键 词：蛛网膜下隙出血 降钙素基因相关肽 脑血管痉挛 

分 类 号：R743.35[医药卫生—神经病学与精神病学]