蛛网膜下隙出血后血浆NO、ET含量变化及氨甲苯酸、尼莫地平对其影响

Changes of NO,ET Content in Plasma after Subarachnoid Hemorrhage and Effect of Aminomethylbenzoic Acid and Calcium Antagonists on Them

目的:探讨蛛网膜下隙出血(SAH)后血浆NO、ET含量变化及抗纤维蛋白溶解药氨甲苯酸和钙拮抗剂尼莫地平对其影响。方法:对120例SAH进行病情评估,随机分为:常规治疗组40例:给予镇静、止痛、脱水脑保护、补液等常规处理;氨甲苯酸(止血芳酸)组40例:在常规治疗基础上,加氨甲苯酸0.2 g,静脉点滴,每日2次,共14 d;尼莫地平组40例:常规治疗加尼莫地平10 mg,静脉点滴,每日1次,共14 d。3组病人分别在发病后247、2 h,71、4、30 d清晨抽取静脉血,检验血浆NO、ET含量;并进行临床预后评估。结果:SAH后血浆NO、ET含量显著升高;氨甲苯酸和尼莫地平组治疗后前者ET含量较常规治疗组明显增高、NO含量无明显变化。结论:NO、ET参与并影响了SAH后复杂的病理生理过程;抗纤维蛋白溶解药和钙拮抗剂部分通过影响ET含量而发挥作用。

Aim：To observe the changes of nitric oxide（NO） and endothelin（ET） contents in plasma after subarachnoid hemorrhage（SAH）, and to investigate the effects of antifibrinolytic therapy and calcium antagonists on their changes. Methods： According to the condition and the age of the patients, 120 cases with SAH were divided randomly into general therapeutic group, add on Aminomethyl benzoic acid group and add on Nimodipine （Nimotop） group. All patients received standard treatment inunediately after being hospitalized for 14 days. The NO and ET concentrations in plasma were examined quantitatively by radioinununologic techniques at 24h, 3d, 7d, 14d after SAH. At 1 month, outcome was assessed with the Glasgow Outcome Scale and the cerebral ischemia and other complications were recorded. Results： ET content in plasma increased significantly after SAH until recovery and difference between 3 groups, while NO content in plasma rose at the beginning, then declined rapidly and had no significant difference between the groups. Conclusion： ET, NO interfered with the complex process of pathologic after subarachnoid hemorrage. Antifibrinolytic therapy and calcium antagonists action on SAH partly depended on affecting content of ET in plasma.