动脉瘤性蛛网膜下腔出血患者脑脊液垂体激素含量变化的临床研究

Clinic research of the cerebrospinal fluid concentration of pituitary hormone in the patients with aneurysml subarachnoid hemorrhage

目的 研究动脉瘤性蛛网膜下腔出血 (SAH )患者脑脊液 (CSF)促肾上腺皮质激素(ACTH)、促甲状腺激素 (TSH )、卵泡刺激素 (FSH)、黄体生成素 (LH)、泌乳素 (PRL)、生长激素 (GH)浓度的动态变化规律。方法 对 40例动脉瘤性蛛网膜下腔出血患者发病后 1～ 3d、7～ 9d、13～ 15d脑脊液ACTH、TSH、FSH、LH、PRL、GH的含量进行动态检测 ,用TCD检测大脑中动脉血流速度(VMCA)。结果 动脉瘤性蛛网膜下腔出血患者CSF中ACTH、TSH、FSH、LH、PRL、GH在发病后 1～3d、7～ 9d各均值明显高于对照组 ,尤以发病后 7～ 9d变化最明显 ;术前、术后有脑血管痉挛组和非脑血管痉挛组也有明显差异。结论 动脉瘤性蛛网膜下腔出血患者脑脊液ACTH、TSH、FSH、LH、GH、PRL含量与病情演变、脑血管痉挛 (CVS)程度有关 ,并可判断预后。

Objective To investigate the relationship between the cerebrospinal fluid concentration of ACTH,TSH,FSH,LH,PRL,GH in 40 cases of subarachnoid hemorrhage and the change of symptom.Methods Dynamical changes of the cerebrospinal fluid concentrations of ACTH,TSH,FSH,LH,PRL and GH during 1～3 days,7～9 days,13～15 days after subarachnoid hemorrhage were observed.TCD was used to measure VMCA.Results All the indexes in 1～3 days,7～9 days after subarachnoid hemorrhage were significantly different from those of the controls,especially in 7～9 days. There was significant difference in the levels of ACTH,TSH,FSH,LH,PRL and GH between CVS and non-CVS before and after operation.Conclusion This findings suggest that there is a positive correlation between the cerebrospinal fluid concentrations of ACTH,TSH,FSH,LH,PRL,GH and the progression of subarachnoid hemorrhage and severity of CVS.