神经系统疾病脑脊液中几种神经肽含量的初步观察

神经肽是一类重要的生物活性多肽,近年的研究提示,神经肽与多种神经疾病的发生有关。本文应用放射免疫分析法对56例不同类型的神经系统疾病患者脑脊液(CSF)精氨酸加压素(AVP)、催产素(OT)、β—内啡肽(β—EP)、生长抑素(SS)和神经降压素(NT)含量进行了观察,以探讨其在神经系统疾病发生中的作用。     

偏头痛患者血浆及脑脊液中神经降压素、精氨酸加压素含量变化的研究

神经肽是体内传递信息的多肽,分布于神经和其他组织,同一个神经肽按其分布不同可能起递质、或激素样作用。神经肽与神经系统疾病的关系正日益受到人们的重视。我们测定了22例偏头痛患者头痛间隙期血浆及其中20例患者脑脊液(CSF)中神经降压素(Neurotensin,NT)、精氨酸加压素(Arginine vasopressin,AVP)两种神经肽的含量,现报告如下。     

妥泰治疗前后癫痫患儿免疫功能变化的研究

目的:探讨癫痫患儿免疫功能的变化及妥泰治疗后免疫功能的改变。方法:分别应用流式细胞术、免疫比浊法、癌细胞花环试验检测了妥泰治疗前后30例癫痫患儿T细胞亚群、免疫球蛋白、红细胞及淋巴细胞免疫粘附功能。结果:癫痫患儿CD4、IgA、IgG、红细胞及淋巴细胞癌细胞花环率明显低于正常对照组(P<0.05)癫痫患儿CD8明显升高,与对照组比较差异显著(P<0.05):应用妥泰6个月后,IgG、红细胞及淋巴细胞癌细胞花环率明显高于未服药前(P<0.05),而IgA、CD4无显著性变化(P>0.05),CD8则较用药前显著上升(P<0.05)。结论:癫痫患儿服药前即存在细胞免疫、体液免疫及天然免疫功能紊乱,妥泰有改善癫痫患儿体液免疫及天然免疫功能的作用,检测癫痫患儿体液免疫及天然免疫功能可作为观察癫痫治疗效果的指标之一。     

天泰1号对自发性老年痴呆模型相关神经肽的影响

目的　观察自发性老年痴呆模型动物相关神经肽的变化及天泰 1号的调节作用。方法　按国际公认方法从老年动物中筛选自发性老年痴呆小鼠 ,随机分为 4组 ,其中第一组为空白对照 ,另 3组分别用Hydergine及中药大、小剂量治疗 ,并设老年正常对照组。结果　 老年痴呆组大脑SS ,AVP ,ACTH含量显著低于老年正常组 (P <0 .0 5 0 .0 1) ;Hydergine组治疗前后无明显变化 ;天泰 1号可显著上调大脑皮质和海马SS ,AVP及ACTH特别是SS的含量 (P <0 .0 5～ 0 .0 1)。结论　自发性老年痴呆模型动物大脑SS ,AVP ,ACTH含量下降 ,天泰 1号对大脑皮质和海马神经肽SS ,AVP ,ACTH特别是SS的代谢有显著的调节作用。     

血管性痴呆患者血浆、脑脊液AngⅡ、AVP、NSE含量的变化及其临床意义

目的了解血管性痴呆(VD)患者血浆、脑脊液(CSF)中血管紧张素Ⅱ(AngⅡ)、精氨酸加压素(AVP)、神经元特异性烯醇化酶(NSE)的质量浓度变化及临床意义. 方法运用简易精神状态量表(MMSE)、P300潜伏期(P300PL)、Hachinski缺血量表(HIS)和社会功能活动调查(FAQ)评定患者认知功能,用放射免疫分析法(RIA)测定血浆、CSF 中AngⅡ、AVP质量浓度,用双抗体免疫夹心法(ELASA)测定血浆、CSF 中NSE质量浓度. 结果 VD组血浆、CSF 中 AngⅡ质量浓度显著高于对照组(P＜0.01),CSF中 AngⅡ质量浓度亦显著高于脑梗死(CI)恢复期(P＜0.01), 血浆AVP质量浓度无显著变化(P＞0.05),CSF 中AVP质量浓度显著降低(P＜0.01),血浆、CSF 中NSE质量浓度同对照组比较明显下降(P＜0.05);直线相关分析VD组血浆与CSF中 AngⅡ、AVP质量浓度变化无显著相关(P＞0.05), 血浆与CSF中NSE质量浓度变化呈直线正相关(P＜0.01). 结论脑内AVP、AngⅡ在VD发病中可能起重要作用,CSF中AVP、AngⅡ质量浓度变化与认知功能密切相关;脑内NSE质量浓度变化与缺血性脑损害的严重程度密切相关,但不能作为反映认知功能的生化指标.     

急性脑血管病患者血浆神经肽Y和神经降压素水平的测定与分析

目的探讨血浆神经肽Y(NPY)、神经降压素(NT)在急性脑血管病患者中的变化及作用。方法应用放射免疫分析方法测定急性脑血管病患者以及正常对照组的神经降压素(NT)和血浆神经肽Y(NPY)水平,并进行比较。结果脑出血组血浆NPY、NT水平均显著高于正常对照组(P0.01);与轻型脑出血组相比,中重型组NPY和NT含量显著升高(P0.01)。脑梗死组血浆NPY显著高于正常对照组(P0.01),NT含量高于正常对照组(P0.05);与轻型脑梗死组相比,中重度型脑梗死患者的NPY和NT含量显著升高(P0.01)。结论急性脑血管病患者血浆NPY和NT水平均升高,且随病情严重程度而增加,可作为反映严重程度的指标。     

阿尔茨海默病患者服用达纳康前后血浆4种神经肽的动态变化

目的　观察早期阿尔茨海默病 (AD)患者服用达纳康 (系法国银杏叶制剂 )治疗前后血浆生长抑素 (somatostatin ,SS)、精氨酸加压素 (argininevasopressin,AVP)、促肾上腺皮质激素 (corticotropin ,ACTH)及β内啡肽 (β endorphin ,β EP) 4种神经肽含量的影响。 方法　对 2 7例早期AD患者于达纳康治疗前后分别取血浆测定上述 4种神经肽含量 ,同时作简易智力状态检查 (MMSE)和韦氏成人智力量表 (中国修订 )(WAIS RC)测评 ,并与 30例正常老年人作对照。结果　AD组血浆AVP含量 (35.8± 1 9.2 4 )ng/L较对照组 (56.3± 2 0 .8)ng/L显著减少 (P <0 0 5) ;血浆SS、ACTH含量在治疗前分别为 (348.8± 2 1 0 .3)ng/L和 (8.2 5± 3 .85)ng/L ,治疗后则分别上升为 (881 .4± 363 .1 6)ng/L和 (1 9± 9.1 1 )ng/L。治疗前后比较均有非常显著性差异 (P <0 .0 0 1 )。AVP在治疗后血浆含量也有升高为 (57.85± 1 6 .86)ng/L,与治疗前比较有显著性差异(P <0 .0 5)。结论　早期AD患者血浆AVP含量减少 ,提示AVP可作为AD患者早期生化指标。早期AD患者在服用达纳康后SS、ACTH、AVP血浆含量均显著上升 ,提示SS、ACTH、AVP可能参与AD的发病机制     

血管性痴呆患者血浆、脑脊液Ang、AVP、NSE含量的变化及其临床意义

目的　了解血管性痴呆 (VD)患者血浆、脑脊液 (CSF)中血管紧张素 (Ang )、精氨酸加压素 (AVP)、神经元特异性烯醇化酶 (NSE)的质量浓度变化及临床意义。方法　运用简易精神状态量表 (MMSE)、P3 0 0潜伏期 (P3 0 0 PL)、Hachinski缺血量表 (HIS)和社会功能活动调查 (FAQ)评定患者认知功能 ,用放射免疫分析法(RIA)测定血浆、CSF中 Ang 、AVP质量浓度 ,用双抗体免疫夹心法 (ELASA)测定血浆、CSF中 NSE质量浓度。结果　VD组血浆、CSF中 Ang 质量浓度显著高于对照组 (P <0 .0 1 ) ,CSF中 Ang 质量浓度亦显著高于脑梗死 (CI)恢复期 (P <0 .0 1 ) ,血浆 AVP质量浓度无显著变化 (P >0 .0 5 ) ,CSF中 AVP质量浓度显著降低 (P <0 .0 1 ) ,血浆、CSF中 NSE质量浓度同对照组比较明显下降 (P <0 .0 5 ) ;直线相关分析 :VD组血浆与CSF中 Ang 、AVP质量浓度变化无显著相关 (P >0 .0 5 ) ,血浆与 CSF中 NSE质量浓度变化呈直线正相关(P <0 .0 1 )。结论　脑内 AVP、Ang 在 VD发病中可能起重要作用 ,CSF中 AVP、Ang 质量浓度变化与认知功能密切相关 ;脑内 NSE质量浓度变化与缺血性脑损害的严重程度密切相关 ,但不能作为反映认知功能的生化指标。     

脑血管病患者血浆神经肽Y和神经降压素浓度的测定及意义研究

目的　研究脑血管病患者在缺血和出血状态下,血浆神经肽Y(NPY)和神经降压素(NT)含量与脑血管病的关系。方法　用放射免疫方法测定脑血管病患者缺血、出血状态下NPY和NT含量。结果　出血性脑血管病患者血浆神经肽Y较对照组有显著提高。缺血性脑血管病患者血浆神经肽Y较对照组无显著差异。脑出血患者的血浆NT含量较正常对照组显著升高,脑梗死患者的血浆NT含量较正常对照组显著降低。结论　出血性脑血管病患者血浆神经肽Y和NT均升高且随病情的好转而降低。缺血性脑血管病患者血浆NT含量降低,且随病情的好转而升高,与血浆神经肽Y无关。     

水痘—带状疱疹感染后的格林—巴利综合征

作者报告2例格林一巴利综合征(GBS)均起病于水痘一带状疱疹之后,观察了血液T淋巴细胞亚群的变化,指出水痘一带状疱疹感染是GBS重要而罕见的触发因素。例1,男,4岁。水痘皮疹消退8天后出现腿痛、四肢瘫痪,肌腱、跖反射消失。腕、膝以下皮肤感觉缺失,跖关节位置觉障碍。正中神经肘-腕段和腓神经腓-踝段运动神经传导速度减慢为32米/秒和22米/秒、脑脊液(CSF)白细胞12个/μ1,蛋白含量1.83克/L。血清及CSF水痘一带状疱疹病毒补体结合试验阳性,免疫萤光检查见CSF细胞内含有水痘一带状疱疹抗原。急性期外周血中抑制T淋巴细胞显著减少,辅助T细胞轻度减少,而CSF中正常。一月后血液中辅助/抑制淋巴细胞比值恢复正     

抑郁症患者脑脊液生长抑素及单胺代谢产物的测定

目的 探讨抑郁症可能的生化病理机制,方法 采用放射免疫测定法及高效液相色谱法,分别测定２７例抑郁症患者和２７例对照者脑脊液（ＣＳＦ）生长抑素（ＳＳ）及单胺代谢产物水平。结果抑郁症组ＧＳＦ中ＳＳ水平和３－甲氧－４羟苯乙二醇（ＭＨＰＧ）水平（Ｐ〈０．０５）和５－羟吲哚乙酸水平（Ｐ〈０．０１）,均低于对照组,而抑制症组ＣＳＦ中高香草酸含量与对照组间的差异无显著性（Ｐ〉０．０５）;抑郁症组ＣＳＦ中ＳＳ与Ｍ     

Cerebrospinal fluid and plasma concentrations of oxytocin and vasopressin during parturition and vaginocervical stimulation in the sheep

Simultaneous blood and cerebrospinal fluid (CSF) samples were taken from conscious sheep before, during and after parturition. Concentrations of plasma and CSF oxytocin were significantly elevated during contractions and particularly at birth. Mean prepartum CSF concentrations of oxytocin were around 55% of those found in plasma but postpartum they were up to 2-fold higher than those in plasma. Plasma concentrations of oxytocin were only significantly elevated, compared to prepartum levels, for 15 min postpartum whereas those in CSF were increased for the whole of the 120 min postpartum sampling period. Plasma, but not CSF, concentrations of arginine-vasopressin (AVP) were significantly raised during contractions and birth, and for 15 min postpartum. During the prepartum period CSF AVP concentrations were 67% of those found in plasma whereas at birth plasma levels were 10-fold higher than in CSF. In a separate experiment it was shown that 5 min of mechanical vaginocervical stimulation also stimulated significant increases in CSF and plasma oxytocin concentrations and in plasma vasopressin. Results support previous work suggesting an important role for central oxytocin release in the postpartum induction of maternal behavior and demonstrate that elevated concentrations of oxytocin in the CSF are present for a greater period than in blood. Elevated plasma AVP concentrations during contractions, birth or vaginocervical stimulation may be stimulated by stress associated with these stimuli.     

癫痫患者血浆及脑脊液中一氧化氮含量的变化与临床意义

采用高效液相色谱法对37例正常对照病人和58例癫痫病人血浆及脑脊液中一氧化氮(NO)含量进行检测。结果显示:癫痫患者血浆及脑脊液中NO含量明显升高,与对照组相比有显著性差异,P均<0.01,且近期有癫痫发作者其血浆及CSF中NO含量较无发作者升高更明显,但与病程、年龄、性别及发作类型、用否抗痫药物无关。提示:NO参与了癫痫发病的病理生理过程。     

Vasopressin and oxytocin in CSF and plasma of patients with aneurysmal subarachnoid haemorrhage

Objective

Clinicopathological studies on patients succumbing to subarachnoid haemorrhage (SAH) demonstrated hypothalamic lesions. The implication of the hypothalamic neuropeptides arginine-vasopressin (AVP) and oxytocin (OXT) has not been linked to aneurysmal SAH yet. This study investigates AVP and OXT in CSF and plasma of patients with spontaneous aneurysmal SAH and their association with outcome.

Methods

CSF and plasma samples of 12 patients with aneurysmal SAH were prospectively studied for 2 weeks. AVP and OXT were measured by radioimmunoassay. Outcome was assessed on Glasgow-Outcome-Scale. Twenty-nine patients without neuropsychiatric disturbances served as controls. Differences in neuropeptide concentration time courses were assessed by regression models. Group comparisons were performed by Kruskal–Wallis and correlations by Spearman tests.

Results

Regression of CSF levels between patients with poor and good outcome revealed significantly lower levels of AVP in patients with poor outcome (p = 0.012) while OXT showed a trend towards lower levels (p = 0.063). In plasma, no significant differences between outcome groups were found. Group comparisons between poor outcome patients and controls revealed significant differences in CSF for AVP (p = 0.001) and OXT (p = 0.015). In plasma, AVP yielded significantly different results while OXT did not. No differences were found between the good outcome group and controls. Plasma and CSF concentrations showed no significant correlation.

Conclusion

Patients with poor outcome after aneurysmal SAH have lower AVP and OXT levels in CSF than patients with good outcome while neuropeptide levels in plasma failed to reflect differences in outcome. The data indicate hypothalamic damage as an aetiologic factor for outcome after aneurysmal SAH.     

Cerebrospinal fluid neurohypophysial peptides in benign intracranial hypertension.

The cerebrospinal fluid (CSF) concentrations of arginine vasopressin (AVP) and oxytocin (OT) were investigated both in patients with benign intracranial hypertension and in age and sex matched controls. Twenty eight lumbar punctures were performed on 15 patients with benign intracranial hypertension as part of their routine investigation and therapy. All patients had raised intracranial pressure (27.4, SE 1.7 cm.CSF). CSF AVP levels were significantly elevated in benign intracranial hypertension (2.1, SE 0.3 pmol/l) compared with controls (0.7, SE 0.1 pmol/l, p less than 0.001) but CSF OT concentrations were similar in both groups. CSF osmolality and plasma AVP and osmolality were identical in patients and controls. There was no correlation between CSF AVP concentration and intracranial pressure. The selective elevation of AVP in CSF may be of importance in the pathogenesis of raised intracranial pressure in benign intracranial hypertension.     

The concentration of homovanillic acid and leucine-enkephalin in the lumbar CSF of patients with Parkinson's disease before and after madopar treatment

For comparison, the concentrations of homovanillic acid (HVA) and leucine-enkephalin (LEK) in the lumbar cerebrospinal fluid (CSF) of patients with Parkinson's disease (PD) before and after treatment with madopar were determined 19 patients, suffering from common surgical diseases, who had CSF withdrawn by lumbar punctures for spinal anesthesia, served as controls. HVA was estimated by fluorescence scanning after polyamide thin-layer chromatography. LEK was measured with radio-immuno-assay. The mean concentration of HVA from 22 patients before madopar treatment (0.085 +/- 0.011 mg/L, means +/- S means) was significantly lower than the control mean value (0.264 +/- 0.022 mg/L) (P less than 0.001); while that of LEK from 25 patients before treatment (197.01 +/- 12.96mg/L, means +/- S means) was significantly higher than the control mean value (88.79 +/- 8.66mg/L) (P less than 0.001). Treatment with madopar increased the concentration of HVA (0.222 +/- 0.032mg/L) (P less than 0.001) but exhibited no significant effect on the levels of LEK. It is confirmed that there is a reduction of HVA in CSF in Parkinsonian patients. The results suggest that an increase of enkephalin in the brain seems to play some role in the pathogenesis of PD, but why madopar could not significantly alter the LEK level in CSF awaits further studies.     

GABA and amino acid concentrations in lumbar CSF in patients with treated and untreated epilepsy

Lumbar free CSF GABA and amino acid concentrations were measured in 43 patients with newly diagnosed untreated epilepsy and 26 patients with chronic drug-resistant epilepsy. The results were compared with those from 51 control patients. No differences in free CSF GABA concentration could be detected between patients with epilepsy, either treated or untreated, and controls. Untreated patients with primary generalised epilepsy and partial seizures had similar free CSF GABA concentrations. These results would not support the hypothesis that patients with epilepsy have a global disturbance of GABA function. CSF taurine, asparagine, aspartate, glycine and alanine were significantly reduced in patients with epilepsy compared to the control population.     

Effect of chlorpromazine treatment on prolactin levels in cerebrospinal fluid and plasma of psychotic patients.

In psychotic patients, levels of prolactin in cerebrospinal fluid (CSF) and plasma were determined by radioimmunoassay before and after 2 and 4 weeks of treatment with chlorpromazine (CPZ). CPZ was given in one of three randomly selected fixed doses: 200, 400 or 600 mg per day. Before treatment, low levels of immunoreactive prolactin-like material (PRL) were found in the CSF of most patients. The concentration in CSF was about 20% of the plasma level. In CSF but not in plasma, the pre-treatment level of PRL was significantly higher in women than in men. During CPZ treatment, the PRL levels in CSF as well as in plasma were significantly elevated in both sexes after 2 as well as 4 weeks. The elevation was significantly greater in women, and was similar at the two time intervals studied. There was a significantly positive relationship between the dose of CPZ and the PRL elevation in both body fluids in both men and women. Before treatment no significant correlation between the PRL levels in CSF and plasma in either sex could be observed. During treatment, there was a significant correlation between the change in PRL levels in CSF and plasma in both men and women. CPZ treatment did not increase the levels of total protein, follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH) or oestradiol-(17-beta) in either the CSF or the plasma.     

Endothelin-1 levels in plasma and cerebrospinal fluidfollowing subarachnoid haemorrhage

A serial measurement of endothelin-1(ET-1) levels in plasma, cisternal and ventricular cerebrospinal fluid(CSF) was performed in 16 patients with subarachnoid haemorrhage (SAH). The patients were classified as grade III or IV according to the clinical grade of Hunt and Hess, and computerised tomography(CT) was classified as Fisher's CT group 3. Cisternal and ventricular CSF and plasma were obtained from the patients on the day of operation days 0-3, days 5-8 and days 14-18 after SAH. ET-I concentration in each sample was quantified by sandwich-enzyme immunoassay. ET-I levels in plasma and CSF were the highest between days 0-3 and then decreased. The ET-I levels in the cisternal CSF were significantly higher during days 0-3(p<0. 01) and days 5-8(p<0. 01) than those in the ventricular CSF It is suggested that ET-I could play an important role in the early stages of the cerebral vasospasm.     

急性颅脑损伤神经降压素含量变化及临床意义

目的和方法应用放免法动态测定51例急性颅脑损伤患者血浆及脑脊液神经降压素含量，以观察神经降压素水平在颅脑损伤组和正常对照组中的变化，并探讨其临床意义。结果颅脑损伤患者急性期血浆及脑脊液神经降压素含量显著高于对照组，且与病情轻重程度明显相关。结论神经降压素参与急性颅脑损伤后继发性病理生理过程；神经降压素受体桔抗剂成为治疗颅脑损伤的有效途径；血浆或脑脊液神经降压素动态含量，可能是判断急性颅脑损伤患者预后的重要因素。