脑卒中患者血浆去甲肾上腺素与自主神经功能障碍的变化及意义  

The study on association between autonomic dysfunction and plasma norepinephrine in stroke patients

作　　者：鲁远君 文治成 贺传沙 瞿伦学 费容 潘乙年[2] 

机构地区：[1]重庆市长寿区人民医院神经内科,401220 [2]第三军医大学基础部中心实验室,重庆400030

出　　处：《重庆医学》2013年第11期1226-1228,共3页Chongqing medicine

基　　金：重庆市卫生局科研基金资助项目(2008-2-382)

摘　　要：目的研究脑卒中患者急性期血浆去甲肾上腺素(NE)与自主神经功能障碍的变化及意义。方法分析88例不同部位初发脑卒中患者和38例健康者,分别在入院后第2、10天抽取患者空腹静脉血3mL于预冷的抗凝管中,4℃低温离心,取上清液置-70℃以下低温保存;采用液质联用法测定脑卒中组及对照组血浆NE水平;记录患者自主神经功能障碍的临床表现;采用美国国立卫生研究院卒中量表(NIHSS)对患者神经功能缺损程度进行评分。结果脑梗死组第2、10天血浆NE水平分别为(1.97±0.26)ng/mL,(2.05±0.25)ng/mL,脑出血组第2、10天血浆NE水平分别为(1.71±0.25)ng/mL,(1.53±0.26)ng/mL,均明显高于对照组(0.54±0.13)ng/mL,差异有统计学意义(P<0.01);脑梗死组第2、10天血浆NE水平明显高于脑出血组,差异有统计学意义(P<0.01);脑梗死组、脑出血组血浆NE水平,第2天与第10天比较,差异无统计学意义(P>0.05);脑卒中组第10天NIHSS评分明显低于第2天,差异有统计学意义(P<0.01)。结论脑卒中患者急性期血浆NE水平明显升高可能与自主神经功能障碍有关联,其中脑梗死组交感神经活性明显高于脑出血组。Objective To study association between autonomic dysfunction and plasma norepinephrine in acute stroke patients.Methods To analyze 88 patients with initial stroke and 38 healthy man.Fasting 3 mL venous blood was taken and put in the anticoagulant tube precooling at the second and tenth days after admission.Centrifuged at 4 ℃,The supernatant was set below-70 ℃.To detect plasma norepinephrine with stroke group and control group by liquid chromatography-mass 1.Spectrometry;To record autonomic dysfunction symptoms and signs with stroke patients,and evaluate neurologic impairment by National Institute of Health Stroke Scale(NIHSS).Results Plasma norepinephrine with cerebral infarction group and cerebral hemorrhage group[(1.97±0.26)ng/mL,(2.05±0.25)ng/mL](1.71±0.25 ng/mL,1.53±0.26 ng/mL)was significantly increased than control group(0.54±0.13 ng/mL) at the second and tenth day after admission.Plasma norepinephrine with cerebral infarction group was significantly increased than cerebral hemorrhage group at the second and tenth day after admission.Compared with the tenth day,plasma norepinephrine was no significant difference in cerebral infarction group and cerebral hemorrhage group at the second day.Compared with left-hemisphere infarction group and hemorrhage group,plasma norepinephrine was no significant difference in right-hemisphere infarction group and hemorrhage group at the second day after admission;Compared with the second day,the score of NIHSS of stroke patients was significantly decreased at the tenth day.Conclusion Autonomic dysfunction in acute stroke patients was probably related with increased plasma norepinephrine.Sympathetic activity with cerebral infarction patients may be higher than cerebral hemorrhage patients.

关 键 词：脑卒中 去甲肾上腺素 自主神经功能障碍 

分 类 号：R743.3[医药卫生—神经病学与精神病学]