摘要
目的 探讨内皮素 (ET) 1、一氧化氮 (NO)与颅内动脉瘤术后脑血管痉挛发生的关系。方法 颅内动脉瘤 3 0例 ,经颅多普勒 (TCD)检测脑血流速度 ,并抽取外周静脉血测定血浆ET 1和NO含量 ,进行手术前后对比研究。另选取 10例健康成人进行对比研究。结果 (1)脑血管痉挛组术后 1～ 3d、5～ 7d血浆ET 1的平均含量明显高于同期未发脑血管痉挛组 (P <0 .0 1) ,与术前和正常组相比差异亦有显著性 (P <0 .0 1)。 (2 )脑血管痉挛组术后 1～ 3d血浆NO的平均含量明显低于术前 (P <0 .0 5 )和术后 5～ 7d(P <0 .0 1) ,术后 5～ 7d脑血管痉挛组的血浆NO平均含量明显高于未发生脑血管痉挛组和正常组 (P <0 .0 1)。结论 (1)颅内动脉瘤术后脑血管痉挛的发生与血浆ET 1、NO平均含量呈明显相关性。 (2 )ET 1/NO在维持脑血管张力上起着重要作用 ,当两者动态平衡破坏时 ,可能导致脑血管痉挛发生。 (3 )对于术后血浆ET 1含量明显升高和 /或NO含量明显降低的患者应及时行经颅多普勒检查 ,有助于尽早发现脑血管痉挛 ,使脑缺血。
Objective To explore the relationship between post operative cerebral vasospasm and plasma endothelin 1 (ET 1) and metabolites of nitric oxide (NO).Methods In 30 cases of intracranial aneurysm,transcranial Doppler (TCD) examination was carried out before operation and 1 3 days and 5 7 days afer operation respectivly,peripheral blood accordingly collected for three times before TCD examination to inspect ET 1 and nitrite and nitrate concentrations.Peripheral blood from 10 health adults was collected to inspect ET 1 and nitrite and nitrate concentrations.Results 1 3 and 5 7 days after operation,plasma ET 1 levels in the vasospasm group were significantly higer than those before operation and the normal control group ( P <0.01).1 3 days after operation plasma NO concentration in vasospasm group was significantly lower than that at the postoperative 5th 7th day and preoperation ( P <0.01).The 5 7 days postoperative plasma concentration was significantly higher than that in the non vasospasm and normal control group ( P <0.01).Conclusion There was significant relationship between the level of plasma ET 1 and NO with the incidence of vasospasm.The dynamic balance of ET 1 and NO may have an important affection on the maintenance of cerebral vessle tone.When the balance was destructed,vasospasm may occur.By the inspection of plasma ET 1 and NO and timely TCD,especially to patients with significantly increased plasma ET 1 concentration and decreased NO concentration after operation,vasospasm may be detected in time,then cerebral ischemia and cerebral infarction may be prevented and treated even effectively.
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2004年第6期676-677,共2页
Chinese Journal of Experimental Surgery
