蛛网膜下腔出血患者血清与脑脊液中NO和CGRP水平变化及意义

目的观察伴和不伴脑血管痉挛蛛网膜下腔出血（SAH）患者血清与脑脊液中一氧化氮（NO）和降钙素基因相关肽（CGRP）水平的变化。方法根据是否合并脑血管痉挛，将53例SAH患者分为有症状脑血管痉挛组、无症状脑血管痉挛组和非痉挛组。72h及1、2、3和4周时分别抽血和采取脑脊液，分别测定血清和脑脊液中NO和CGRP水平。结果出血后，三组患者脑脊液和血清NO与CGRP水平逐渐降低，1～2周时降低最明显，随后逐步回升；1、2、3周时痉挛组血清和脑脊液中NO和CGRP水平较非痉挛组明显降低。结论SAH后脑脊液和血清NO与CGRP水平降低可能是引起脑血管痉挛的重要因素。

Changes and value of NO and CGRP in serum and CSF of subarachnoid hemorrhage patients

Objective] To study changes of nitric oxide(NO) and calctonin gene-related peptide(CGRP) in serum and CSF of subarachnoid hemorrhage(SAH) patients with and without delayed cerebral vasospasm.Methods] 53 cases of SAH were divided into symptomatic cerebral vasospasm group,asymptomatic cerebral vasospasm group and nonvasospasm group.Serum and CSF specimen were obtained at 72 h, 1 w,2 w,3 w and 4 w after subarachnoid hemorrhage,and levels of NO and CGRP in serum and CSF were detected.Results] After onset of SAH,NO and CGRP levels in serum and CSF of all cases began to decrease,and reached the bottom between 1 w and 2 w,then increased gradually;NO and CGRP levels in serum and CSF of cases in vasospasm groups were lower than those of nonvasospasm groups,and there were significant differences.Conclusion] Lower levels of NO and CGRP in serum and CSF maybe the critical factors for cerebral vasospasm after SAH.