ET和NO在脑出血中的变化以及硫酸镁的干预作用  

Dynamic Changes of ET and NO in ICH and the Intervention Role of MgSO_4

作　　者：武婕[1] 章柏松[2] 

机构地区：[1]南京医科大学附属南京第一医院神经内科,南京210006 [2]苏州大学附属第一医院神经内科,苏州215006

出　　处：《中国血液流变学杂志》2004年第1期32-36,137,共6页Chinese Journal of Hemorheology

摘　　要：目的　阐明脑出血 (ICH)患者血浆内皮素 (ET)和血清一氧化氮 (NO)的动态变化规律 ,并用硫酸镁干预治疗 ,探讨镁离子在脑出血中的神经保护作用。方法　将 4 5例ICH患者分为两组 ,出血组 2 5例 ,给予临床常规治疗 ;出血干预组 2 0例 ,加用 2 5 %的硫酸镁 2 0ml静脉滴注。两组患者分别检测起病第 1、3、7、14d的血浆ET和血清NO水平 ,并且分析血浆ET、NO变化水平与出血部位、出血量的大小、以及神经功能缺损评分的相关性。结果　出血组患者血浆ET水平在起病第 1、3、7d明显高于对照组 (P <0 .0 5 ) ,尤以第 3d为高峰 ,以后逐渐降低 ,第 14d接近对照组水平 (P >0 0 5 ) ,且ET水平在起病第 3d随出血量的增大而升高 ,而与病情轻重及出血部位无明显相关性。出血干预组第 3、7d血浆ET水平均低于出血组 (P <0 .0 5 ) ,且ET水平下降快 ,至第 7d已接近对照组水平 (P >0 .0 5 )。出血组患者血清NO水平在起病第 1d即达高峰 ,起病第 1、3dNO水平与对照组相比显著升高 (P <0 .0 5 ) ,以后逐渐降低 ,至第 7d恢复至对照组水平。NO水平与病情轻重、出血部位以及出血量的大小无明显相关性。出血干预组与出血组相比亦无显著性差异 (P >0 .0 5 )。ET与NO之间无明显相关性。结论　ICH患者急性起病后 。Objective To demonstrate the characteristics of dynamic changes of endothelin (ET) and nitric oxide (NO) in patients withintracerebral hemorrhage(ICH) and investigate the clinical effects of magnesium sulfate in neural protection. Methods Fortyfive patients with ICH are devided into two groups, twenty-five in routine therapy,and twenty using MgSO 4 besides routine methods.Plasma level of ET and serum level of NO are measured in all patients serially on the 1st day, the 3rd day, the 7th day and the 14th day. Results The level of ET significantly elevates on the 1st day、 the 3rd day and the 7th day, the level of ET is highst on the 3rd day,then decreases gradually,on the 14th day it returns to the control concentrations.The elavation of ET is correlated positively with the amount of hemorrhage (P<0.05), but has no correlation with the sites of hemorrhage nor the clinical severities. The plasma level of ET is lower in the intervention group with MgSO 4, and decreases faster.It reaches the control concentrations on the 7th day,and there is significant difference between two ICH groups on the 3rd and 7th day(P<0.05). The serum level of NO significantly elevates on the 1st and 3rd days It reaches peak on the 1st day, thereafter, begins to decrease.It returns to the control concentrations on the 7th day. The serum level of NO doesn't be correlated with the clinical severities, nor the amounts of hemorrhage, or the sites of hemorrhage.There is no significant difference between two ICH groups (P>0.05). The level of NO and the level of ET have no relationship.Conclusion The alteration of ET and NO levels is remarkable in patients with acute intracerebral hemorrhage.It may reflect that ET and NO play an important role in the process of hemorrhage pathophysiology. The plasma level of ET has a positive relationship with the amounts of hemorrhage,the level of ET significantly decreases in the group using MgSO 4 than the group with routine methodes,it may reflect that magnesium sulfate has neural protection to some extent

关 键 词：ET NO 脑出血 硫酸镁 干预作用 内皮素 一氧化氮 

分 类 号：R743.34[医药卫生—神经病学与精神病学]