出血性脑血管病患者血浆兴奋性氨基酸的临床研究

Clinical Study of Excitatory Amino Acids in Patients with Hemorrhagic Cerebrovascular Disease

目的 探讨兴奋性氨基酸含量在出血性脑血管病中的变化规律及临床意义。方法 应用高效液相色谱法测定42例出血性脑血管病患者(包括脑出血30例,蛛网膜下腔出血8例,脑室出血4例)和20例正常人血清谷氨酸(Glu)、天门冬氨酸(Asp),进行患者自身前后对照及与正常人比较。结果 出血性脑血管病患者急性期血浆中Glu、Asp含量均显著高于对照组(P<0.001);恢复期血浆中Glu、Asp均下降(P<0.01),其中Glu在2周后降至正常,而Asp仍较正常组高;急性期患者的出血量与Glu、Asp含量呈正相关r_G 0.809、r_A 0.675(P<0.01)。结论 兴奋性氨基酸可能参与出血性脑血管病的急性脑损伤。

Objective To investigate manifestations of the plasmic excitatory amino acids in the patients with hemorrhagic cerebrovascular diseases. Methods Using high performance liquid chroma-tography (HPLC) , we determined the glutamate (Glu) and aspartate (Asp) concentrations in the plasma of 42 cases with hemorrhagic cerebrovascular disease (including 30 cases with cerebral hemorrhage and 8 cases subarachnoid hemorrhage and 4 cases ventricular hemorrhage) and compared with 20 cases control subjects. Results The results showed that plasma concentrations of Glu, Asp of the patients in acute period were significantly higher than those of the control group (P< 0. 001) and they both decreased in the convalescent period (P < 0. 01). In contrast with Glu that reduced to normality, the plasma concentration of Asp in the convalescent period is higher than that of the control group (P < 0. 01). There was a significant positive correlation between the volume of cerebral hemorrhage and the plasma concentrations of Glu, Asp in acute phase (rG = 0. 809, rA = 0. 675, both P<0. 01). Conclusions The excitatory amino acids (Glu, Asp) may take part in the acute brain injury of hemorrhagic cerebrovascular disease.