外伤性蛛网膜下腔出血患者急性期血浆及脑脊液中ET和NO含量变化

目的：本文旨在探讨外伤性蛛网膜下腔出血(tSAH)患者早期血浆及脑脊液中内皮素Ⅰ(ET1)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液和脑脊液中ET含量；采用硝酸还原酶法测定血液和脑脊液中NO的代谢产物NO—X(NO-2和NO-3)含量。结果：提示tSAH患者SAH后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，且临床症状的严重程度与ET增高和NO下降的程度密切相关。本实验结果支持SAH后CVS发生机制中ET与NO动态平衡破坏学说。结论：ET、NO在tSAH后的脑血管痉挛中起着十分重要的作用。

The Changes of Plasma and CSF ET and NO Level in Patients with Subrachnoid Hemorrhage

Objective:To evaluate the changes of plasma and cerebrospinal fluid(CSF) level of endothelin(ET) and nitric oxide(NO) contents (CSF),and the effects of they on the developement of cerebral vasospasm (CVS) and clinical symptom of subrachnoid hemorrhage (SAH).Methods:The level of ET was assayed by radioimmunological technique,and level of NO was done by HNO3 reductase method.Results:The ET contents of both plasma and CSF in tSAH patients were singnifcantly higher than those in normal group (P<0.05) ,and the ET contents on serious group were higher than those in middle group(P<0.05).The NO contents in the same patients were significantly lower than those in normal group(P<0.05) and the NO contents in serious group were lower than those in middle group(P<0.05).Conclusions:The appearance of CVS following tSAH and the delayed cerebral ischemia were due to continuous constriction of cerebral artery,which was mediated by the increase of ET content and the reduce of NO content.Verity of clinical symptom was in positive correlation to the raised degree of ET content and the reduced degree of NO content.It suggested that the disturbance of ET and NO plays an important role in the mechanism of CVS development tSAH attact.