蛛网膜下腔出血患者脑脊液血管收缩因子表达变化

Changes in the expression of vasoconstrictors in cerebrospinal fluid from patients with subarachnoid hemorrhage

研究背景脑血管痉挛是蛛网膜下腔出血最为常见的严重并发症之一,是引起预后不良的主要危险因素,与脑脊液血管收缩因子表达变化密切相关。本研究对蛛网膜下腔出血患者脑脊液内皮素-1(ET-1)、血管紧张素Ⅱ(AngⅡ)和血栓素B2(TXB2)表达水平进行检测,探讨其与脑血管痉挛间的关系。方法纳入2018年9月至2019年1月共18例蛛网膜下腔出血患者,分别于发病后<3 d(10例)、3~5 d(8例)、>5~7 d(9例)、>7~d(7例)和≥10 d(6例)采集脑脊液标本,采用酶联免疫吸附试验测定ET-1、AngⅡ和TXB2水平。结果蛛网膜下腔出血后,各时间点脑脊液AngⅡ(P=0.041)和TXB2(P=0.050)水平差异有统计学意义,其中AngⅡ至发病≥10 d显著降低,并低于发病后<3 d(P=0.009)和发病后>5~7 d(P=0.000),TXB2至发病后>5~7 d达峰值(P=0.036,0.008),此后逐渐下降,但与峰值水平差异无统计学意义(均P>0.05);而ET-1水平不同观察时间点差异无统计学意义(P>0.05)。结论蛛网膜下腔出血患者脑脊液AngⅡ和TXB2表达随疾病进展呈现动态变化,可能与脑血管痉挛的发生发展密切相关。

Background Cerebral vasospasm(CVS)is one of the common severe complications in previous studies showed,CVS is closely related to the changes in the expression of vasoconstrictors in cerebrospinal fluid(CSF).In the present study,we measured the levels of endothelin-1(ET-1),angiotensinⅡ(AngⅡ)and thromboxane B2(TXB2)in SAH patients’CSF to demonstrate the relationship with CVS.M ethodsA total of 18 patients with SAH were enrolled from September 2018 to January 2019.CSF samples were collected within 3 d,3-5 d,>5-7 d,>7-d and≥10 d after SAH.The levels of ET-1,AngⅡand TXB2 were detected by enzyme-linked immune sorbent assay(ELISA).ResultsThe levels of AngⅡ(P=0.041)and TXB2(P=0.050)in CSF at different time points were significantly different.The level of AngⅡat≥10 d after SAH was significantly lower than that at<3 d(P=0.009)and>5-7 d(P=0.000)after SAH.The level of TXB2 reached the peak at>5-7 d after SAH(P=0.036,0.008),and then gradually decreased without significance.The level of ET-1 in CSF at different time points were not different(P>0.05,for all).ConclusionsThe levels of AngⅡand TXB2 in SAH patients’CSF present dynamic variation with the progression of the disease.This may be involved in the occurrence of CVS.