盐酸法舒地尔对蛛网膜下隙出血后血浆和脑脊液中内皮素-1和一氧化氮水平的影响

目的 观察盐酸法舒地尔对蛛网膜下隙出血(SAH)患者血浆和脑脊液中内皮素(ET)-1、一氧化氮(NO)水平变化的影响,探讨盐酸法舒地尔对SAH后脑血管痉挛(CVS)的防治作用.方法 60例SAH患者,按照随机数字表法随机分为治疗组30例(给予常规治疗+盐酸法舒地尔治疗)和对照组30例(给予常规治疗),入院第2天及第10天采用经颅多普勒(TCD)测定脑血流速度,放射免疫分析法测定血浆和脑脊液中ET-1、NO水平.结果 治疗组CVS发生率(6.67%,2/30)明显低于对照组(36.67%,11/30)(P<0.05);而入院第2天两组血浆和脑脊液中ET-1、NO水平比较差异均无统计学意义(P>0.05);人院第10天,治疗组血浆和脑脊液中ET-1水平较对照组明显降低[(118.23±14.56)ng/L比(132.26±15.18)ng/L,(138.23±16.58)ng/L比(156.24±17.54)ng/L],NO水平较对照组明显升高[(88.25±15.54)μmol/L比(70.26±14.86)μmol/L,(104.27±16.52)μmol/L比(92.43±12.51)μmol/L],两组比较差异均有统计学意义(P<0.05).结论 盐酸法舒地尔能减少SAH患者CVS的发生,可能是通过阻止血浆和脑脊液中ET-1水平升高和NO水平降低而发挥作用.

Effects of fasudil hydrochloride injections on endothelin-1 and nitric oxide contents in plasma and cerebrospinal fluid after subarachnoid hemorrhage

Objective To observe the effects of fasudil hydrochloride injections on the levels of endothdin(ET)-1,nitric oxide(NO)in plasma and cerebrospinal fluid(CSF)in patients with subarachnoid hemorrhage(SAH),and analyze,its mechanisms in preventing cerebral vasospasm(CVS).Method Sixty SAH cases were randomly divided into fasudil group(30 cases)and control group(30 cases).On 2nd and 10th day after in hospital,the speed of cerebral blood flow was measured by transeranial Doppier(TCD),and the levels of ET-1,NO in plasma and CSF were measured by radio-immunity.Results The incidence of CVS in fasudil group were significantly less than those in control group[6.67%(2/30)vs 36.67%(11/30),P<0.05].On the 10th day,the levels of ET-1 in plasma and CSF in fasudil group were signitlcandy lower than those in control group[(118.23±14.56)ng/L vs(132.26±15.18)ng/L,(138.23±16.58)ng/L vs (156.24±17.54)ng/L ](P<0.05),the levels of NO were significantly higher than those in control group [(88.25±15.54)μmol/L vs(70.26±14.86)μmol/L,(104.27±16.52)μmol/L vs(92.43 ±12.51)±mol/L](P<0.05).But there were no significant difference on the 2nd day(P>0.05).Conclusion Fasudil can reduce CVS in patients with SAH by lowering the levels of ET-1 and increasing the levels of NO in plasma and CSF.