急性脑血管病患者血浆一氧化氮、垂体加压素、泌乳素的变化

Changes of plasmatic vasopressin, prolactin and nitricoxide in patients with acute cerebrovascular disease

目的探讨不同时期、病情、梗死面积和出血量的急性脑血管病患者(ACVD)血浆中一氧化氮(NO)、垂体加压素(AVP)、泌乳素(PRL)的变化及临床意义.方法脑梗死(CI)、脑出血(CH)患者,分别按意识障碍和肌力状况分为轻、重组.CI按梗死面积分为大梗死组、多发梗死组及单发性小梗死组;CH按出血量多少分为小于20ml组;20～40ml组;大于40ml组;据不同病程分为急性期(发病后1小时至3天),恢复期(住院3周后).对照组:30例同期健康体检者,测定对照组及患者入院时和3周后血浆中NO、AVP、PRL的水平.结果CI、CH患者NO、PRL、AVP均高于正常人,且病情越急,病情越重,脑梗死面积和出血量程度越大者,升高越明显,升高程度与患者愈后密切相关.至恢复期CI、CH患者NO、PRL、AVP已恢复正常.结论急性脑血管疾病患者急性期AVP、NO、PRL升高,可作为判断ACVD的严重程度和愈后的参考指标.

Objective To elucidate the clinical value on changes of plasmatic vasopressin （AVP） , nitricoxide （NO） , and prolactin （PRL） in different periods, different area of infarction and volume of hemorrhage in patients with acute cerebrovascular disease （ACVD）. Methods Fifty cases of cerebral infraction, 50 cases of cerebral hemorrhage and 30 cases of controls were recruited in this series. The diagnostic criterion was in accordance with that of cerebrovascular disease formulated in 1995. The patients were classified according to the period of onset, the levels of consciousness and muscle power, the result of CT, and the volume of hemorrhage. Results The levels of NO, PRL, AVP in ACVD patients were higher than those of control ones （P〈0.05） , which were closely correlated with the clinical prognosis. The levels of NO, PRL, AVP returned to normal in recovery phase. Conclusion The levels of AVP, NO, PRL in ACVD can be used to assess the severity and prognosis. It is suggestive that these cases can be cured by iNOS-inhibitor, nNOS-inhibitor, AVP-receptor-antagonist, PRL- receptor-antagonist and the monoclonal antibody.