脑出血患者血浆中ET—1,SP含量变化及临床意义

目的动态观察３０例脑出血患者血浆内皮素－１（ＥＴ－１）、Ｐ物质（ＳＰ）含量变化。方法应用放射免疫分析法（ＲＩＡ）。结果（１）急性期血浆ＥＴ－１、ＳＰ含量显著高于对照组。（２）急性期血浆ＥＴ－１、ＳＰ含量显著高于恢复期。（３）急性期血浆ＥＴ－１含量与ＳＰ含量呈正相关。结论ＥＴ－１、ＳＰ共同参与和影响脑出血的病理生理过程，血浆ＥＴ－１、ＳＰ含量的增高在一定程度上反映了脑出血的严重程度     

小儿病毒性脑炎患者内皮素—1含量的研究

采用放射免疫均相竟争法，测定５６例急性病毒性脑炎（ＡＶＥ）患儿的血浆和脑脊液（ＣＳＦ）中内皮素－１（ＥＴ－１）含量。结果发现，ＡＶＥ急性期患儿血浆ＥＴ－１含量明显高于疾病对照组和正常对照组（Ｐ＜０．０１），急性期血浆和ＣＳＦ中ＥＴ－１含量高于恢复期（Ｐ＜０．０１），血浆与ＣＳＦ中ＥＴ－１含量呈正相关（ｒ＝０．８５８，Ｐ＜０．００１），病情严重、抽搐频繁、ＥＥＧ和脑ＣＴ或ＭＲＩ显示病变部位广泛者，血浆和ＣＳＦ中ＥＴ－１含量增高更为显著。认为ＥＴ－１是一种新的内源性致病因子，在ＡＶＥ病程发展与转归中起重要作用。     

脑梗塞急性期及恢复期血浆一氧化氮及相关因素测定分析

本文测定脑梗塞急性期及恢复期血浆一氧化氮（ＮＯ）、内皮素（ＥＴ）、前列环素（ＰＧＩ２）及血栓素Ａ２（ＴＸＡ２）的含量，结果示脑梗塞急性期组血浆ＮＯ、ＥＴ、ＴＸＡ２含量明显高于恢复期组及对照组，血浆ＰＧＩ２含量急性期组明显低于恢复期组及对照组，血浆ＮＯ与ＥＴ呈显著正相关，与ＰＧＩ２呈显著负相关。由此探讨脑梗塞时ＮＯ及其它参与血管舒缩因子的变化及临床意义。     

脑梗塞患者血浆内皮素和血管紧张素Ⅱ变化的临床观察

目的探讨内皮素（ＥＴ）和血管紧张素Ⅱ（ＡⅡ）在脑梗塞中的作用及相互关系。方法应用放射免疫分析法同步测定３０例脑梗塞患者和３０例正常对照者血浆ＥＴ和ＡⅡ含量。结果脑梗塞急性期血浆ＥＴ和ＡⅡ含量均较正常对照组显著升高（Ｐ均＜０．０１），且中－重度脑梗塞组两者均显著高于轻度组（Ｐ均＜０．０１）。急性期血浆ＥＴ与ＡⅡ呈显著正相关（ｒ＝０．７０３３，Ｐ＜０．０１），恢复期（ｒ＝０．２４６５，Ｐ＞０．０５）和正常对照组（ｒ＝０．１８３７，Ｐ＞０．０５）无显著相关。结论脑梗塞时血浆ＥＴ和ＡⅡ增高并与病情严重程度相一致。内源性ＥＴ与ＡⅡ具有正反馈调节关系，两者相互作用可能在脑梗塞发病和进展过程中起重要作用     

脑梗塞患者血浆和脑脊液中内皮素-1、降钙素基因相关肽含量的研究

用放免法检测４０例脑梗塞患者脑脊液和不同病期血浆中内皮素－１（ＥＴ－１）、降钙素基因相关肽（ＣＧＲＰ）的含量并与对照组比较。结果：脑梗塞患者脑脊液中ＥＴ－１含量无明显改变（Ｐ＞０．０５），ＣＧＲＰ含量显著降低（Ｐ＜０．０１）。发病２周内血浆ＥＴ－１含量明显高于对照组（Ｐ＜０．０５），而发病４周内ＣＧＲＰ值却显著低于对照组（Ｐ＜０．０１）。患者是否伴高血压、神经功能缺损轻重、梗塞灶大小对血浆ＥＴ－１和ＣＧＲＰ含量均无明显影响。     

中风病人血浆内皮素动态变化及其与病情关系的研究

用放免法测定９８例中风病人的血浆内皮素（ＥＴ）含量在不同病情、病程时期的动态变化。结果发现ＩＴＡ与脑供血不足患者ＥＴ水平明显高于对照组（Ｐ＜０．０５）；脑梗塞患者急性期及恢复期ＥＴ水平均较对照组有显著差异（Ｐ＜０．０１），且梗塞范围越大ＥＴ水平增高越显著；ＳＡＨ病人发病后１周ＥＴ水平迅速上升高达数倍，４周后即降至原有水平。结果表明ＥＴ参与了中风的发生与发展，是引起缺血损伤和脑血管痉挛的重要因素。     

脑梗塞患者血浆和脑脊液中内皮素—1,降钙素基因相关肽含量…

用放免法检测４０例脑梗塞患者脑脊液和不同病期血浆中内皮素－１（ＥＴ－１）、降钙素基因相关肽（ＣＧＲＰ）的含量并与对照组比较。结果：脑梗塞患者脑脊液中ＥＴ－１含量无明显改变（Ｐ〉０．０５），ＣＧＲＰ含量显著降低（Ｐ〈０．０１）。发病２周内血浆ＥＴ－１含量明显高于对照组（Ｐ〈０．０５），而发病４周内ＣＧＲＰ值却显著低于对照组（Ｐ〈０．０１）。患者是否伴高血压、神经功能缺损轻重、梗塞灶大小对血浆ＥＴ－１     

脑梗塞患者血浆β—内啡肽及强啡肽A1—13含量的变化

应用放射免疫分析法对４２例脑梗塞患者血浆β－ＥＰ、ＤｙｎＡ１－１３含量进行了测定。结果显示，脑梗塞急性期且梗塞灶体积大者血浆β－ＥＰ含量明显升高，ＤｙｎＡ１－１３含量显著降低（Ｐ＜０．０５）。脑梗塞病情程度越重，β－ＥＰ含量升高越明显，两者呈正相关（ｒ＝０．０５）。提示内源性阿片肽在缺血性脑梗塞中具有重要作用，β－ＥＰ促进了脑损伤缺血性脑水肿的形成和发展，而ＤｙｎＡ１－１３对其可能具有保护作用。     

尼莫地平对脑梗塞患者血浆中内皮素的调节作用研究

随机将６４例脑梗塞患者分成常规治疗组和常规加用尼莫地平组，并检测血浆内皮素含量，结果表明急性期内皮素１（ＥＴ－１）含量明显高于康复期及对照组（Ｐ＜０　．００１），康复期尼莫地平组ＥＴ－１含量较常规治疗组要明显低（Ｐ＜０．０１）。ＥＴ－１含量的变化与全身应激反应有关，而及时应用钙离子拮抗剂能减少内皮素分泌，有利于神经系统征恢复，改善预后。     

脑梗死患者血液和脑脊液ET_1及VEGF的同步检测及与病变关系

目的 探讨内皮素（ＥＴ１）和血管内皮细胞生长因子（ＶＥ ＧＦ）在脑梗死发病中的意义及其相互关系。方法 分别应用放免法测定脑梗死患者血浆和脑脊液中ＥＴ１及ＥＬＩＳＡ法测定血清和脑脊液中ＶＥＧＦ。结果 脑梗死组血浆和脑脊液中ＥＴＩ含量明显高于对照组,急性期更高,而且脑脊液中ＥＴ１的增加（Ｐ＜０．０１）比血浆中的ＥＴ１增加（Ｐ＜０．０５）更显著;血清和脑脊液中ＶＥＧＦ含量在急性期均明显高于对照组,恢复期下降。脑脊液中ＶＥＧＦ含量与病情轻重有关,而血浆ＥＴ１含量与梗死灶大小有关。以梗死灶大小为参照、急性期血浆ＥＴ１与血清ＶＥＧＦ两者呈正相关;以病情轻重为参照,急性期脑脊液中ＥＴ１与ＶＥＧＦ两者呈正相关。结论 脑梗死患者血液和脑脊液中ＥＴ１及ＶＥＧＦ的不同变化表明,两者都参与了脑梗死的发病过程,且具有相关性,ＥＴ１和ＶＥＧＦ均与脑梗死的发生发展密切相关。     

山莨菪碱对急性颈髓损伤后血浆及脑脊液中内皮素-1含量的影响

目的：研究山莨菪碱（654－2）对内皮素－1（ET－1）水平的影响。方法：用放免法（RIA）测定急性颈髓损伤患血浆及脑脊液中ET－1含量。结果：急性颈髓损伤后血浆及脑脊液ET－1明显升高，经山莨菪碱治疗组ET－1较创伤对照组明显下降。结论：急性颈髓损伤后神经元坏死可能与ET－1水平升高有关，山莨菪碱可通过降低ET－1水平而发挥对脊髓神经元的保护作用。     

Increased plasma endothelin-1 levels in patients with intracerebral hemorrhage

Endothelins (ETs) are discovered peptides that are widely distributed in neurons and nonneuronal cells of the human nervous system. Previous studies showed that ischemic stroke may be associated with increased plasma ET-1 levels. There are no studies to show plasma ET-1 levels in intracerebral hemorrhage. Plasma ET-1 levels in 30 patients with cerebral hemorrhage within 72 hours after the onset of focal neurological deficit were measured by a microplate enzyme immunoassay. Thirty sex- and age-matched healthy subjects were accepted as a control group. The clinical neurological status in the patients was evaluated according to the modified Matthew Scale. The mean plasma ET-1 level in hemorrhagic stroke patients was significantly higher than in control subjects (2.39±2.08 v 0.65±0.32 fmol/mL, (P < .05). There was a significant difference in ET levels between patients who died in the hospital and patients who survived (P < .05). The mean ET-1 concentration in patients with severe neurologic deficit was significantly higher than in patients with mild neurologic deficit (P < .05). There was a correlation between hematoma volumes and plasma ET-1 levels in the patients (r = 0.66, Pt < .001). The mean plasma ET-1 concentration was found to be significantly higher in patients with intraventricular hemorrhage than in patients without intraventricular hemorrhage (P < 0.05). There were no significant differences in ET-1 levels between supratentorial and infratentorial subgroups or among supratentorial subgroups (P > .05). It was concluded that plasma ET-1 levels were increased in the acute period of hemorrhagic stroke. Plasma ET-1 levels may be associated with hematoma volume, which is related to a poor prognosis of the cerebral hematoma. We suggest that increased plasma ET-1 levels may be a consequence of local cerebral hemorrhage or the acute stress condition of the disease.     

脑损伤患者血浆内皮素、降钙基因相关肽水平变化及纳洛酮的疗效分析

目的 观察纳洛酮对脑损伤患者血浆内皮素（ET）、降钙基因相关肽（CGRP）水平的影响。方法用放射免疫测定法测定创伤性脑损伤患者血浆ET-1、CGRP水平变化。结果创伤性脑损伤后血浆ET水平明显升高．病情越重升高越明显。纳洛酮治疗后血浆ET-1水平下降较对照组明显。CGRP早期（1d）较对照组升高明显。结论创伤性脑损伤后患者血浆ET-1水平升高．且与病情严重程度有关。早期应用纳洛酮可显著降低ET-1和提高CGRP水平．并获得良好治疗效果。     

尼膜酮对蛛网膜下腔出血患者血浆内皮素和降钙素基因相关肽的影响

目的探讨血浆内皮素(ET)和降钙素基因相关肽水平(CGRP)在蛛网膜下腔出血病人急性期中的变化。方法采用放射免疫分析技术,在42例蛛网膜下腔出血病人的急性期测定血浆ET和CGRP含量,并与35例健康人员作比较。结果蛛网膜下腔出血病人血浆ET含量在尼膜酮治疗后有所下降(P<0.05),而CGRP的浓度升高(P<0.05)。结论血浆ET在蛛网膜下腔出血的急性期显著升高,并与脑损伤程度有关,提示神经肽参与出血性脑损伤的发生发展过程;尼膜酮可能对ET-1和CGRP有治疗作用。     

Endothelin and aneurysmal subarachnoid haemorrhage: a study of subarachnoid cisternal cerebrospinal fluid.

Endothelin (ET) is considered one of the most potent vasoconstrictor polypeptides; several experimental studies have suggested its possible role in the pathogenesis of arterial vasospasm after subarachnoid haemorrhage (SAH). Previously reported data on plasma and CSF levels of endothelin in patients with a diagnosis of SAH have been controversial. Cisternal endothelin CSF levels and the possibility that they could be related to vasospasm and other clinical patterns of SAH were investigated. CSF samples were obtained from 55 patients admitted after angiographic diagnosis of intracranial aneurysm. Levels of ET-1 and ET-3 were measured through radio-immunoassay technique. Twelve patients who had operations for unruptured aneurysms were considered control cases; 43 patients with SAH were classified according to: Hunt and Hess grading at admission, vasospasm grading, CT classification and timing of surgery. In all 55 patients ET-1 was measured, while positive levels of ET-3 were found only in 17 cases of 48. No linear correlation was found between cisternal CSF ET-1 levels when considering time of surgery, CT classification, Hunt and Hess grading at admission, and vasospasm grading. The results of ET-3 assay should be considered with great caution because of the low percentage of positive cases. Cisternal CSF levels of ET-1 and ET-3 are not directly related to the occurrence of arterial vasospasm after the aneurysm rupture, or to other major clinical patterns of SAH; however, ET-1 expression occurs either in paraphysiological (unruptured aneurysm) or in pathological conditions (SAH). It is suggested that ET may potentiate, or may be potentiated by, other factors playing a consistent pathophysiological role in the development of vasospasm.     

急性颅脑损伤患者血清ET-1、SE-CAD及镁离子的动态变化与意义

目的探讨急性颅脑损伤（aTBI）患者血清血清内皮素-1（ET-1）、可溶性上皮钙黏蛋白（SE-CAD）及镁离子的动态变化及其意义。方法将100例aTBI患者分为轻、中型组（GCS 9~15分,66例）和重型组（GCS〈8分34例）,另将40例健康体检者作为对照组。测定血清ET-1、SE-CAD及镁离子的水平,比较各组ET-1、SE-CAD及镁离子水平的变化。结果轻、中型组和重型组伤后24 h内血清ET-1、SE-CAD明显高于对照组（P〈0.05）,而镁离子水平明显低于对照组（P〈0.05）。重型组伤后24 h内血清ET-1、SE-CAD明显高于轻、中型组（P〈0.05）,而镁离子水平明显低于轻、中型组（P〈0.05）。重型组治疗后血清ET-1、SE-CAD较治疗前明显增高（P〈0.05）,而镁离子水平较治疗前明显降低（P〈0.05）。结论 ET-1、SE-CAD及镁离子可能参与aTBI后颅内的病理生理变化,其对判定伤情及预后具有重要的临床参考价值。     

脑损伤大鼠血浆及海马内皮素—1、肿瘤坏死因子变化的实验研究

用RIA法测定脑损伤大鼠血浆及海马匀浆中ET-1、TNF-a含量变化,研究ET-1、TNF-a对海马神经原坏死的影响。结果:血浆及海马ET-1、TNF-a水平在脑损伤后各时间点均明显高于对照组,二者具有显著相关性;且ET-1、TNF-a含量变化与病程有关。结论:脑损伤后ET-1、TNF-a增高是引起海马缺血、神经原坏死的重要原因。     

厄贝沙坦对急性脑梗死患者血浆溶血磷脂酸、内皮素-1和血清一氧化氮含量的影响

目的研究厄贝沙坦对急性脑梗死患者血浆溶血磷脂酸（LPA）、内皮素-1（ET-1）和血清一氧化氮（NO）含量的影响。方法将53例急性脑梗死患者随机分为厄贝沙坦治疗组（25例）和常规治疗组（28例）,并以23例非脑血管病患者和7名健康志愿者作为对照组。厄贝沙坦治疗组给予厄贝沙坦150mg＋阿司匹林100mg,常规治疗组给予阿司匹林100mg,每天1次,其余治疗方法相同,连续治疗14d。分别在治疗前后抽取静脉血检测LPA、ET-1和NO含量,并对两脑梗死组治疗前后进行神经功能缺损程度评分（NDS）。结果（1）脑梗死患者血LPA、ET-1含量较对照组显著升高（均P〈0.05）,NO含量显著降低（P〈0.05）;NDS与NO含量呈负相关（r=-0.4345,P〈0.05）。（2）厄贝沙坦治疗组和常规治疗组治疗后血LPA、ET-1含量和NDS较治疗前显著降低（均P〈0.05）,NO含量显著升高（均P〈0.05）。（3）治疗后厄贝沙坦治疗组与常规治疗组相比,血LPA、ET-1、NO含量改善更为明显（均P〈0.05）。结论厄贝沙坦能显著降低急性脑梗死患者血LPA、ET-1含量,提高血NO水平,显示其有抗血小板活化及内皮保护作用。