论文部分内容阅读
目的 探讨蛛网膜下腔出血后脑血管痉挛与血管活性物质的关系。方法 测定52例蛛网膜下腔出血患者血浆血栓素B_2(thromboxane B_2,TXB_2)、6-酮-前列环素F1α(6-keto-prostaglandin,6-Keto)及血浆和脑脊液中血管紧张素转化酶(angiotensin converting enzyme,ACE)活性,同时通过经颅多普勒超声检查法(transcranial Doppler nltrasonography,TCD)观察蛛网膜下腔出血后脑血管平均血流速度(Vm)的变化,并与正常对照组进行比较。结果 蛛网膜下腔出血患者血浆TXB_2水平高于对照组(P<0.01),6-Keto水平低于对照组(P<0.05或P<0.01);发病后血浆ACE活性无明显改变,但脑脊液中ACE活性高于对照组(P<0.01);大脑中动脉平均血流速度于蛛网膜下腔出血后第4～5d的变化最为显著(P<0.01)。结论 蛛网膜下腔出血后患者血浆TXB_2、6-Keto与脑脊液ACE水平均发生明显变化,结合TCD检测结果,推测蛛网膜下腔出血后脑血管痉挛与血管活性物质水平有关。
Objective To investigate the relationship between cerebral vasospasm and vasoactive substances after subarachnoid hemorrhage. Methods Thromboxane B2, 6-keto-prostaglandin (6-Keto) and plasma levels of angiotensin converting enzyme (ACE) in 52 patients with subarachnoid hemorrhage were measured. (ACE) activity was measured. The change of mean cerebral blood flow velocity (Vm) after subarachnoid hemorrhage was observed by transcranial Doppler nltrasonography (TCD), and was compared with that of the normal control group Compare Results The levels of plasma TXB_2 in patients with subarachnoid hemorrhage were significantly higher than those in the control group (P <0.01), and the levels of 6-Keto were lower than those in the control group (P <0.05 or P <0.01) ACE activity was higher than that of the control group (P <0.01). The mean velocity of middle cerebral artery was the most significant change after 4 ~ 5d (P <0.01) after subarachnoid hemorrhage. Conclusions Plasma levels of TXB 2, 6-Keto and cerebrospinal fluid ACE in patients with subarachnoid hemorrhage have significant changes. Combined with TCD results, it is speculated that cerebral vasospasm is related to vasoactive substances after subarachnoid hemorrhage.