不同病程及部位脑血管病下丘脑-垂体-肾上腺皮质轴功能改变的研究

目的：对脑血管病（ＣＶＤ）患者进行不同病程、不同病变部位下丘脑垂体肾上腺（ＨＰＡ）机能改变的观察研究。方法：应用放免分析法，对１７２例ＣＶＤ患者（脑出血６８例、脑梗死１０４例）检测血清ＡＣＴＨ、皮质醇含量。结果：急性期ＣＶＤ患者血清ＡＣＴＨ、皮质醇含量水平明显高于对照组，尤以脑出血为著，差异均有显著性（Ｐ＜０．０５～０．０１）。恢复期时，其含量水平明显下降，但仍高于对照组，差异有显著性（Ｐ＜０．０５）。不同病变部位ＣＶＤ时，血清ＡＣＴＨ、皮质醇含量不同，呈现丘脑＞基底节＞脑叶的趋势。结论：ＣＶＤ时，随病程延长、病症好转，ＨＰＡ机能紊乱具有可逆性；不同部位ＣＶＤ时ＨＰＡ机能成应激性增强；脑组织病损后神经介质变化也可能为ＨＰＡ机能改变的重要因素。

Study on the functional change and its clinical significance of the HypothalamicPituitaryAdrenocortical Axis of cerebral vascular disease in different site and course

Objective :To study the functional change of the HypothalamicPituitaryAdrenocortical Axis (HPA) of cerebral vascular disease (CVD) in different position and course. Methods :The levels of serum ACTH and Cortisol (Cor) in 172 patients with CVD (68 patients with cerebral hemorrhage,104 patients with cerebral infarction). Result :The level of ACTH and Cor was significantly higher than the control group (P<0.050.01) and it decreased in convalescent stage,but it also was significantly higher than control (P<0.05).The level of ACTH and Cor was different in different brain regions of CVD.There was a tendancy of thalamus>Basal Ganglia>Cerebral lobes (P<0.05). ConclusionBZ:With protration and recovery of CVD,the function disorder of HPA has reversibility.The funtion of HPA enhance stressly.On the other hand,its maybe a major factor of the functional change of HPA that the change of neurohormone after lesion of brain tissue.