脑梗死病变与内皮素-1及血管内皮细胞生长因子的关系

背景内皮素-1(endothelin-1,ET-1)和血管内皮细胞生长因子(vascularendothelial growthfactor,VEGF)在蛋白及核酸水平方面的研究多见于动物实验,而ET-1和VEGF与临床脑梗死病变方面关系的研究还未广泛开展.目的探讨脑梗死发病中ET-1和VEGF的变化规律及机制.设计完全随机对照研究.地点和对象选自2000-03/06中国医科大学第二临床学院神经内科住院脑梗死患者27例及同期在本院正常体检老年人22例.干预患者先行头CT或MRI检查,发病第3天及4周抽取肘静脉血,分别采用放免法及ELISA法测定血浆中ET-1和血清中VEGF含量.主要观察指标血浆中ET-1和血清中VEGF含量.结果脑梗死组ET-1及VEGF含量[(65.7±10.8)ng/L,(419.5±176.3)ng/L]均高于对照组[(48.8±6.9)ng/L,(205.7±101.8)ng/L],两组比较差异有显著性意义(t=2.015,P＜0.05,t=2.705,P＜0.01);到恢复期时有所下降[ET-1含量为(60.2±11.5)ng/L,VEGF含量为(309.4±138.9)ng/L],与对照组比较,差异有显著性意义(t=2.028,P＜0.05;t=2.724,P＜0.01).ET-1及VEGF含量与梗死灶的大小及病情程度有关.结论ET-1及VEGF与脑梗死的发生、发展密切相关,从而为脑卒中预防及康复干预提供实验依据.

Relation of pathologic change of cerebral infarction with endothelin-1 and vascular endothelial growth factor

BACKGROUND:The animal experimental research on changing rules of the endothelin-1 (ET-1) and the vascular endothelial growth factor(VEGF) is more than that in protein and nucleic acid level, however, the research of relationship between ET-1 and VEGF in clinical pathologic change of cerebral infarction has not yet been studied.OBJECTIVE: To investigate the changing rules and the mechanism of ET-1and VEGF in cerebral infarction.DESIGN: A completely randomized case-control study.SETTING and PARTICIPANTS: Twenty-seven hospitalized patients with cerebral infarction in Neurology Department of Second Hospital of China Medical University and 22 senior citizens having health examination were selected from March to June in 2000 .INTERVENTIONS: CT or MRI of head was performed first, and the blood of elbow vein was taken on the third day and 4 weeks after onset. The content of ET-1 in the plasm and VEGF in the blood serum were tested with radioimmunoassay and enzyme-linked immunosorbent assay(ELISA).MAIN OUTCOME MEASURES: The content of ET-1 in plasma and the content of VEGF in blood serum.RESULTS: The contents of ET-1 and VEGF[ (65.7 ± 10. 8) ng/L and (419.5 ± 176.3) ng/L] in cerebral infarction group were higher than that in control group[ (48.8 ± 6.9) ng/L and (205.7 ± 101.8) ng/L], and there was a significant difference between the two groups( t =2. 015, P < 0.05;t = 2. 705, P < 0.01 ) ); The contents of ET-1 and VEGF were decreased in the convalescence phase[the content of ET-1 was(60. 2 ± 11.5) ng/L; the content of VEGF was(309.4 ± 138.9) ng/L], and there was a significant difference compared to that in the control group (t = 2. 028, P < 0. 05;t = 2. 724, P<0. 01 ). The contents of ET-1 and VEGF were related with the infarct focal size and the state of illness.CONCLUSION: ET-1 and VEGF are closely related with the occurrence and development of cerebral infarction,thus it provides the experimental basis for the prevention and rehabilitation intervention of stroke.