脑出血患者血浆去甲肾上腺素、乙酰胆碱与自主神经功能障碍的相关性研究  

Correlation between autonomic neurological dysfunction and levels of plasma norepineprine and acetylcholine in patients with cerebral hemorrhage at acute phase

作　　者：鲁远君 贺传沙 文治成 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,长寿401220 [2]第三军医大学基础部中心实验室,重庆400038

出　　处：《重庆医科大学学报》2013年第6期630-633,共4页Journal of Chongqing Medical University

基　　金：重庆市卫生局科研资助项目(编号:2008-2-382)

摘　　要：目的:研究脑出血患者急性期血浆去甲肾上腺素(norepineprine,NE)、乙酰胆碱(acetylcholine,Ach)的水平与自主神经功能障碍的相关性。方法:分析45例不同部位初发脑出血患者和38例健康人,分别在入院后第2、10天清晨抽取患者空腹静脉血3 ml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。分别采用液质联用法、酶联免疫吸附法测定脑出血组及对照组血浆NE及Ach水平;记录患者自主神经功能障碍的临床表现;应用自主神经症状量表(autonomic symptom profile,ASP)对脑出血组及对照组进行评估;采用美国国立卫生研究院卒中量表(national institutes of health stroke scale,NIHSS)对患者神经功能缺损程度进行评分。结果:脑出血组第2、10天血浆NE水平[(1.71±0.25)、(1.53±0.26)ng/ml]明显高于对照组(0.54±0.13)ng/ml,差异有统计学意义(P=0.006、P=0.003),而血浆Ach水平[(76.88±12.38)、(71.75±12.73)ng/L]明显低于对照组(105.61±14.27)ng/L,差异有统计学意义(P=0.005、P=0.008),脑出血组血浆NE、Ach水平第2、10天比较,差异无统计学意义(P=0.054、P=0.342);脑出血组ASP评分明显高于对照组,差异有统计学意义(P=0.002、P=0.010),脑出血组ASP评分与血浆NE、Ach水平存在统计学相关性(r=0.770,P=0.042;r=-0.868,P=0.011)。脑出血组第10天NIHSS评分明显低于第2天,差异有统计学意义(t=5.91,P=0.008)。结论:脑出血患者急性期血浆NE水平明显升高而血浆Ach水平明显降低,血浆NE及Ach水平的变化可能与自主神经功能障碍有关联。Objective：To study the correlation between autonomic neurological dysfunction and levels of plasma norepineprine（NE） and acetylcholine（Ach） in patients with cerebral hemorrhage at acute phase.Methods：Totally 45 patients with initial cerebral hemorrhage in different sites and 38 healthy man were enrolled.Fasting 3 ml venous blood was taken and put in the anticoagulant tube precooled at the 2 nd and 10 th d after admission.Centrifuged at 4 ℃,the supernatant was set below-70 ℃.Plasma NE levels of cerebral hemorrhage group and control group were detected by liquid chromatography-mass spectrometry and Ach levels by ELISA.Symptoms of autonomic neurological dysfunction were recorded.Autonomic symptom profile（ASP） was used to evaluate hemmorrhage group and control group.Degrees of neurologic impairment were evaluated by national institutes of health stroke scale（NIHSS）.Results：Levels of plasma NE were significantly higher in cerebral hemorrhage group[（1.71±0.25） ng/ml and（1.53±0.26） ng/ml] than in control group[（0.54±0.13） ng/ml] at the 2 nd and 10 th d after admission（P=0.006,P=0.003）,whereas,levels of plasma Ach [（76.88±12.38） ng/L and（71.75±12.73） ng/L] were significantly decreased in cerebral hemorrhage group than in control group [（105.61±14.27） ng/L] with statistical differences（P=0.005,P=0.008）.There was no significant difference in levels of plasma NE and Ach between at the 2nd d and the 10 th d（P=0.054,P =0.342）.ASP scores were significantly increased in hemorrhage group than in control group at the 2nd d and the 10 th d（P=0.002,P=0.01）.Statistical correlations between ASP scores and levels of plasma NE and Ach were existed（r=0.770,P=0.042;r=-0.868,P=0.011）.NIHSS scores were significantly lower at the10 th d than at the 2nd d（P=0.008,t=5.91）.Conclusions：Levels of plasma NE are significantly increased and plasma Ach are obviously decreased in patients with cerebral hemorrhage at acute phase.Changes in levels of plasma NE and Ach are

关 键 词：脑出血 液质联用法 去甲肾上腺素 乙酰胆碱 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]