慢性高原病对脑血管反应性及血管调节因子的影响  

Chronic mountain sickness modulated cerebrovascular reactivity and biological effects on the related vascular responses cytokines

作　　者：郝贵生[1] 吴世政[1] 

机构地区：[1]青海省人民医院神经内科,西宁810007

出　　处：《中国神经精神疾病杂志》2016年第7期390-394,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：省部级基金(编号:2013-Z-921)

摘　　要：目的探讨慢性高原病(chronic mountain sickness,CMS)对脑血管反应性(cerebrovascular reactivi-ty,CVR)及部分血管调节因子的影响。方法纳入CMS患者26例及健康对照组23例,采用经颅多普勒超声(transcranial doppler ultrasoiund,TCD)评估CVR,同时采用酶联免疫吸附实验检测CMS患者和健康人血清内皮素(endothelin 1,ET-1)及其受体(endothelin receptor B,ETBR)、内皮型一氧化氮合酶(endothelial nitric oxide syn-thase,e NOS)的血浆含量。结果 CMS患者CVR(3.84±3.01)数值明显低于健康人CVR(6.39±6.87),差异有统计学意义(P<0.05);CMS患者血清ETBR浓度高于健康组[(386.07±281.57)μg/μL vs.(312.30±238.07)μg/μL],差异具有统计学意义(P<0.05)。CMS患者血清e NOS水平与健康组相比,无统计学差异[(31.47±10.78)pg/μL vs.(38.28±13.89)pg/μL,P>0.05];CMS患者血清中的ET-1为(42.04±20.29)pg/μL,而健康组为(41.89±17.87)pg/μL,两者无统计学差异(P>0.05)。结论 CMS患者的脑循环储备力明显低于健康人;CMS患者与健康人群血浆中ET-1、e NOS对血管的调节作用能力基本相同;CMS患者的脑血管的低氧舒张与ETBR的高表达密切相关。此研究可为慢性高原病人群血液高凝状态下脑梗死的预防和治疗提供科学依据。Objective To investigate the influence of the chronic mountain sickness （chronic mountain sickness, CMS） on Cerebrovascular reactivity （CVR） and regulators of cerebrovascular responses. Methods Twenty-six CMS patients and 23 healthy control group using transcranial Doppler ultrasound （Transcranial Doppler Ultrasoiund, TCD） assessment of CVR, enzyme-linked immunosorbent assay were applied to measure the serum levels of the endothelin （endothelin 1 , ET-1） and its receptor （endothelin receptor B, ETBR）, endothelial nitric oxide synthase （endothelial nitric oxide synthase, eNOS） in CMS patients and healthy control. Results CVR （3.84 ± 3.01） was significantly lower in CMS patients than in the healthy control CVR （6.39 ± 6.87） （P 〈0.05）; the serum concentration of ETBR in CMS patients was higher than in control [（386.07±281.57）μg/μL vs.（312.30±238.07）μg/μL] （P〈0.05）. Conclusions The cerebral circulation reserve in CMS patients is significantly lower compared with healthy people. The regulation of vascular capacity by serum ET-1 and eNOS is similar between CMS patients and healthy control. The hypoxic vasodilatation in CMS patients is closely associated with cerebrovascular high expression of ETBR. This study may provide a scientific basis for the prevention and treatment of cerebral infarction in the patients with chronic mountain sicknes.

关 键 词：慢性高原病 脑血管反应性 血管调节因子 

分 类 号：R594.3[医药卫生—内科学] R743.3[医药卫生—临床医学]