重型颅脑外伤后血管痉挛与脑脊液NO及内皮素水平的关系

Relationship between vasospasm and NO,ET-1 level in cerebrospinal fluid on patients with severe post-craniocerebral trauma

目的探析重型颅脑外伤后脑血管痉挛(CVS)和脑脊液一氧化氮(NO)及内皮素(ET-1)水平的相关性。方法入选我院2012-02—2014-02收治的重型颅脑外伤后CVS患者124例作为观察对象,根据CVS严重程度分为重度组40例,中度组42例,轻度组42例,入选同期重型颅脑外伤后未发生CVS的40患者作为对照组,检测患者入院后1d、3d、5d及7d时双侧大脑中动脉(MCA)和颈内动脉颅外段(ICA)脑血流速度及脑脊液NO、ET-1水平。结果 CVS各组NO浓度均显著低于对照组,且CVS重度组NO浓度显著低于中度组,中度组显著低于轻度组;ET-1呈相反变化。结论颅脑外伤后CVS的发生可能与脑脊液中NO抑制,ET-1升高,破坏血管舒张收缩平衡相关。

Objective To investigate the relationship between vasospasm （CVS） and NO, ET-1 level in cerebrospinal flu- id （CSF） on patients with severe post-craniocerebral trauma. Methods 124 patients with CVS after severe craniocerebral trau- ma from February 2012 to February 2014 were divided into severe group （n=40）, medium group （n=42） and mild group （n= 40）. 40 patients without CVS after severe craniocerebral trauma in the same time were chosen as control group. The cerebral blood flow velocity （CBFV） in MCV and ICA, and the NO, ET-1 levels in CSF at 2d, 3d, 5d and 7d after admission of all patients were detected. Results The NO concentration of CVS groups was lower than that of control group. There were the lowest NO concentration in CVS severe group and the higher NO concentration in CVS mild group. The ET-1 level changes of CVS groups had an opposite tendency with NO concentration changes. Conclusion The patients with CVS occurrence after cranioce- rebral trauma may have a correlation with NO decreasing and ET-1 increasing in CSF to destroy the balance between vasodila- tion and vasoconstriction.