脑血管病患者CGRP的临床研究

A clinical study on levels or calcitonin gene-related peptide in plasma in patients with cerebrovascular disease

目的：1．观察脑出血（CH）、脑梗死（CI）患者降钙素基因相关肽（CGRP）水平改变及其动态变化；2观察CH、CI病情、病灶大小与CGRP水平变化的关系；3．研究CGRP与脑血管病（CVI））伴发疾病的关系；4．探讨CGRP参与各型CVD及其伴发病中的病理生理机制及其临床意义，并探讨其异常分泌的可能机制；5探讨CVD防治的新途径。方法：选择CVD1I8例，其中CH组46例．CI组62例。用放免法检测血浆CGRP浓度。结果：1．CI组CGRP的变化：显著低于对照组，发病24h内即显著降低，2～3d与4～7d则进一步降低，8～15d开始升高，15d后逐渐升至正常水平。伴发病积分＞6分组显著低于＜6分组，高血糖组显著低于正常血糖组。2．CH组CGRP的变化：显著低于对照组．发病24h内即显著降低，2～3d与4～7d进一步降低，8～15d有所升高，15d后进一步升高，仍低于正常水平。随病情加重，脑出血量增加，CGRP水平明显降低。结论：l．CICH患者存在CBRP分泌异常，CGRP参与了CVD的病理生理过程。2．各组CVD、CGRP动态检测可作为病情严重程度、病灶大小及预后的重要指标。3．本研究结果提示，调整CGRP的分泌将有助于改善各组CVD的预后．并为应用CGRP治疗缺血性脑损伤提供了广阔的前景。

Objective: To obseive levels of calcitonin gene-related peptide in plasma in patients withcerebra1 hemorrhage or cerebral infarction. To observe the relationship between the levels of calcitoning6ne-re1ated peptide in plasma in patients with cerebral hemorrhage or cerebral infarction and patient'scondition and focus of infection- To study the relationship between the levels of calcitonin gene-relatedpeptide in plasma with cerebral himorrhage or cerebral inFarction. To investigate the clinical significance ofcalcitonin gene-related peptide in pathogenetic and pathophysiological mechanism of cerebral hemorrhageand cerebral infarction. Metheds: The levels of calcitonin gene-related peptide in plasma were measured byradioimmunoassay in 108 cases with cerebrovascular disease and 28 helthy control subjects. 108 patientswere divided into cerebral hemorrhage group (46cases) and cerebral infarction grouP (62 cases ). Results:The level of plasma calcitonin gene-related peptide in groups of cerebral infarction and cerebral hemorrhagecut down more than that in control group. The plasma calcitonin gene-related peptide started to decreasesignificantly in groups of cerebraI hemorrhage and cerebral infarction during the first day. It decreasedfurther on day 1 to 3 and day 4 to 7, lt started to increase from the eighth day, but it was also lower thanthat in controI group. The resuIts showed that there was a significant correlation between plasma levels ofcalcitonin gene-related peptide and the patient's condition and the size of focus of infection of cerebralinfarction, cerebral hemorrhage. Conclusion: Calcitonin gene-related peptide play a major role inpathophysiological and pathogenetic mechanisms of cerebral infarction and cerebral hemorrhage-