脑卒中患者急性期血浆一氧化氮水平变化的意义

背景研究表明一氧化氮可能参与了脑卒中的病理过程,但其作用的研究结果具有争议性.目的观察脑卒中患者血浆一氧化氮含量的变化情况,探讨一氧化氮在脑卒中发生发展过程中的作用和意义.设计病例-对照研究.单位一所市级医院的神经内科,血液科,检验科.对象选择确诊为脑卒中的患者为研究对象,其中脑梗死47例,脑出血42例,正常对照组41例,均为健康体检者和献血者.方法采用硝酸还原酶法分别测定研究对象入院时、发病后的第3,7,21天的一氧化氮含量,并与健康体检者进行对照.主要观察指标各组患者血浆一氧化氮含量.结果脑梗死组入院时、发病后的第3,7天的血浆一氧化氮含量比正常对照一氧化氮含量低,差异有显著性(P＜0.01);第21天的血浆一氧化氮含量比入院时高(P＜0.01),且与正常对照组比较差异无显著性意义(P＞0.05).脑出血组入院时、发病后的第3,7,21天的一氧化氮含量分别为(60.70±21.56)μmol/L,(55.19±28.53)μmol/L,(5851±28.53)μmol/L,(62.13±23.30)μmol/L,比正常对照组低(t=4.386 8,t=4.747 6,t=4.1873,t=3.969 8,P＜0.01),且连续4次检验的血浆一氧化氮含量没有明显变化,差异无显著性意义(P＞0.05).脑梗死组前3次的血浆一氧化氮含量与脑出血同期的血浆一氧化氮含量比较差异无显著性意义(P＞0.05);脑梗死组第21天的血浆一氧化氮含量比脑出血第21天的血浆一氧化氮含量高(t=3.3436,P＜0.01).结论脑卒中患者存在低水平的血浆一氧化氮含量,脑出血患者的低水平血浆一氧化氮含量比脑梗死患者持续时间更长,一氧化氮可能参与了脑卒中的病理过程.

Significance of the changes in serous nitrogen oxides level at the acute stage of patients with cerebral apoplexy

BACKGROUND: As indicated by researches, nitrogen oxides(NO) might participate in the pathological process of cerebral apoplexy; however, the results on its effects are controversial.OBJECTIVE: To observe the alteration of serous NO level in patients with cerebral apoplexy for the exploration of the effects and significance of NO in the generation and development of cerebral apoplexy.DESIGN: A case controlled trial.SETTING: Department of Neurology, Hematology, and Laboratory Medicine of some tertiary hospital.PARTICIPANTS: Confirmed cerebral apoplexy patients were selected as subjects including 47 patients of cerebral infarct, and 42 patients of cerebral hemorrhage. A total of 41 healthy volunteers selected from the individuals for physical check up and blood donators were in normal control group.METHODS: Nitrate reductase method was used to detect the NO content of the patients on the admission day, the 3rd day, 7th day, and 21st day after onset. The results were compared with that of the control group.MAIN OUTCOME MEASURES: Serous NO contents of the subjects in each group.RESULTS: The serous NO contents of the patients in cerebral infarct group on the admission day, the 3rd day and the 7th day after onset were all significantly lower than that of control group( P ＜ 0.01); the serous NO content on the 21st day was significantly higher than that of the admission day( P ＜ 0.01 ) but no significant difference from that of control group (P ＞ 0.05 ) . The serous NO contents of the patients in cerebral hemorrhage group on the admission day, the 3rd day, the 7th day and the21st day were(60.70±21.56) μmol/L, (55.19±28.53) μmol/L,(58.51 ± 28.53) μmol/L, and(62.13 ± 23.30) μmol/L respectively,which were significantly lower than that of control group( t = 4. 386 8, 4. 747 6,4. 187 3, 3. 969 8, P ＜0. 01), and moreover, the serous NO contents had no significant improvements in 4 continuous tests( P ＞ 0.05) . There were no significant differences of serous NO contents in the former 3 times of cerebra infarct group compared with that of cerebral hemorrhage group at same time point ( P ＞ 0.05). The serous NO content on the 21st day in patients of cerebral infarct group was significantly higher than that of cerebral hemorrhage group( t = 3. 343 6, P ＜ 0.01).CONCLUSION: Low level of serous NO content exists in patients with cerebral apoplexy, which lasts longer in patients with cerebral hemorrhage. NO might participate in the pathological process of cerebral apoplexy.