血管活性物质与急性脑梗死的相关性及脑局部亚低温治疗对其的影响

目的 探讨血管活性物质在脑梗死发生、发展中的作用及局部亚低温治疗的效果。方法 将73例急性重症脑梗死患者分为亚低温组36例及常规组37例；两组均予常规治疗，亚低温组加用脑局部亚低温治疗。检测两组治疗前后血清血管活性物质神经肽（NPY）、降钙素基因相关肽（CGRP）、神经降压素（NT）、内皮素（ET-1）水平，并与32例健康人（对照组）比较，治疗前后行临床神经功能缺失评分。结果 73例患者治疗前NPY、CGRP、NT、ET-1均明显高于对照组；治疗后7、15d逐渐下降；亚低温组明显低于常规组（P〈0．05）；治疗30d亚低温组临床神经功能缺失评分明显低于常规组（P〈0．01）。结论 血管活性物质在脑梗死发生、发展中起重要作用；局部亚低温治疗可促进急性脑梗死患者神经功能缺损恢复，明显改善预后；其可能机制为调节血管活性物质水平。

Correlation between the vasoactive substances and acute severe cerebral infarction and effects of local mild hypothermia on it

Objective To investigate the effect of vasoactive substances in the occurrence and development of acute severe cerebral infarction and the therapeutic effect of local mild hypothermia. Methods seventy-three patients with acute severe cerebral infarction were divided into mild hypothermia group（ 36 cases）and control group （37 cases）. Both groups were given regular treatment , and the mild hypothermia group was given local mild hypothermia therapy for further. The level of vasoactive substances （NPY, CGRP, NT,ET-1 ）in plasma before and after treatment were measured, and compared with 32 healthy controls （health group）. The scores of clinical neurological deficit were observed too. Results The levels of NPY,CGRP,NT,ET-1 in plasma of two patients groups were significantly higher titan those in the health group（ P 〈 0. 01 ）. The levels of vasoactive substances of the patients decreased gradually 7 and 15 days after the treatment,and which in the mild hypothermia group were significantly lower than those in the control group （P 〈 0.05）. The scores of clinical neurological deficit in mild hypothermia group were significantly lower than those of the control group at the first month after treatment （P 〈 0.01 ）. Conclusion Local mild hypothermia therapy can obviously promote the nerve function deficient recovery and improve prognosis of cerebral infarction patients remarkably ; the possible mechanism is adjusting the level of vasoactive substances.