血管活性物质与蛛网膜下腔出血后脑血管痉挛的关系

The relationship between the vasoactive agents and cerebral vasospasm after subarachnoid hemorrhage

目的 :研究蛛网膜下腔出血 (SAH)后血管活性物质变化及与脑血管痉挛 (CVS)的关系。方法 :测定SAH病人血浆TXB2 、6 -酮及血浆和脑脊液血管紧张素转化酶 (ACE)的活性 ,并与健康对照组相比较 ;在观察临床病情发展的同时通过经颅多普勒超声 (TCD)检测病人脑血管的平均血流速度 (Vm)。结果 :与对照组相比 ,病人组血浆TXB2 、6 -酮含量有显著差异 ;脑脊液ACE活性显著升高 ;Vm在SAH后 4～ 5天增快明显 ;病情于SAH后 3～ 7天较为严重。结论 :SAH后血浆TXB2 、6 -酮、脑脊液ACE含量发生明显变化 ,结合TCD检测结果和临床观察 。

Objective:To study the relationship between cerebral vasospasm after subarachnoid hemorrhage(SAH) and vasoactive agents.Method:The activity of thromboxane B 2(TXB 2),6-keto-prostaglandin F 1α(6-Keto) in plasma and angiotensin converting enzyme(ACE) of plasma and cerebrospinal fluid were measured,cerebral blood flow velocities were monitored by trascranial Doppler ultrasonography(TCD),while the clinical feature were observed.Result:The significant difference of TXB 2,6-Keto in plasma between the normal control group and patients group existed,cerebrospinal fluid activity of ACE increased obviously;mean flow velocities of celebral arteries increased significantly in four to five days after SAH,clinical features deteriorated after three to seven days.Conclusion:Since levels of TXB 2,6-Keto in plasma and ACE in cerebrospinal fluid after SAH significant change,considering result of TCD and the clinical features,cerebral vasospasm after SAH correlate with vasoactive agents.