外伤性蛛网膜下腔出血血管痉挛与ET和NO的关系

目的探讨外伤性蛛网膜下腔出血(tSAH)患者早期血浆及脑脊液(CSF)中内皮素(ET)和一氧化氮(NO)与脑血管痉挛及临床病情之间的关系。方法采用放射免疫方法测定血浆和CSF中ET含量;采用硝酸还原酶法测定血浆和CSF中NO含量。结果tSAH痉挛组血浆和CSF中ET含量均显著高于非痉挛组(P<0.05),重症痉挛组明显高于轻症痉挛组(P<0.05)。痉挛组血浆和CSF中NO-X含量均低于非痉挛组(P<0.05),且重症痉挛组明显低于轻症痉挛组(P<0.05)。结论ET、NO在tSAH后的脑血管痉挛中起着十分重要的作用,脑血管痉挛和迟发性脑缺血可能系ET升高和NO下降,使大脑动脉持续收缩所致。其临床症状的严重程度与ET增高和NO下降的程度密切相关。

ENDOTHELIN AND NITRIC OXIDE CONCENTRATION IN PATIENTS WITH POSTRAUMATIC SUBRACHNOID HEMORRHAGE CEREBRAL VASOSPASM

Objective To evaluate the relations between endothelin(ET) and nitric oxide(NO) contents of blood and cerebrospinal fluid(CSF) and the development of cerebral vasospasm(CVS) and clinical symptom of subarachnoid hemorrhage(SAH) patients with brian injury.Methods The content of ET was assayed by radioimmunological technique,and NO was by HNO3 reductase method.Results The ET contents of both blood and CSF in SAH patients were singnifcantly higher than those in normal group(P<0.05),and the ET contents in serious group were higher than those in slight group(P<0.05).The contents of both blood and CSF in the same patients were singnifcantly lower than those in normal group(P<0.05) and the NO contents in serious group were lower than those in slight group(P<0.05).Conclusion The occurrence of CVS following SAH and the delayed cerebral ischemia is due to continuous constriction of cerebral artery,which is mediated by the increase of ET content and the decrease of NO content,and the degree of clinical symptoms is in positive correlation to the raised degree of ET content and the reduced content of NO content.It suggests that the disturbance of ET and NO plays an important role in the mechanism of CVS development cerebral Vasospasm following tSAH.