脑出血患者血浆ET-1、CGRP和NSE变化及临床应用

Clinical Significance of Changes of Plasma ET-1,CGRP and NSE Levels in Patients with Cerebral Hemorrhage

目的:观察脑出血患者急性发作期、恢复期血浆内皮素(ET-1)、降钙素基因相关肽(CGRP)和神经元特异性烯醇化酶(NSE)的含量变化,探讨它们在脑出血不同时期的临床意义。方法:脑出血组60例,健康对照组60例。脑出血组分别于入院次日、第7d、第21d空腹静脉采集血液标本。用放射免疫分析ET-1、CGRP、NSE含量。结果:脑出血组各时间的ET-1、CGRP和NSE均高于健康对照组,与对照组比较,差异有统计学意义(P<0.01)。ET-1、CGRP发病次日与第7d含量比较,差异无统计学意义(P>0.05),与第21d含量比较,差异有统计学意义(P<0.01);NSE发病次日含量与第7d、21d比较,差异有统计学意义(P<0.01),第7d与第21d含量比较,无统计学意义(P>0.05)。结论:脑出血患者血浆ET-1、CGRP和NSE水平发病次日显著升高。恢复期ET-1、CGRP、NSE含量较发病次日逐渐下降。测定血浆ET-1、CGRP和NSE含量有助于脑出血患者的早期诊断和预后判断,具有重要的临床价值。

Objective To observe the clinical significance of dynamic changes of content of plasma endothelin （ET-1）, calcitenin gene - related pepdde （CGRP） and neuron specific enolase （NSE） in patients with acute cerebral hemorrhage. Methods Plasma ET -1, CGRP （with RIA） and NSE （with RIA） contents were measured dynamically on d2, d7 and d21 after onset of disease in 60 patients with acute cerebral hemorrhage and once in 60 controls. Results Plasma contents of ET -1, CGRP and NSE in the patients were significantly higher than those in controls all the time tested （P 〈0.01）. The plasma contents of ET- 1 and CGRP in patients on d2 and d7 were not significantly different （ P 〉 0.05）, but the contents on d2 were significantly higher than those on d21 （P〈0.01）. Plasma contents of NSE in patients on d2 were significantly higher than those on d7 and d21 （P 〈0.01）, but contents on d7 and d21 were not significantly different （P 〉 0.05）. Conclusion Plasma ET - 1, CGRP and NSE levels in patients with cerebral hemorrhage patients were significantly increased on the 2nd day, then decreased gradually during convalescence. Determination of plasma ET-1, CGRP and NSE levels would help to diagnose cerebral hemorrhage earlier and predict prognosis with important clinical value.