Objective. - To investigate changes in the levels of calcitonin gene- related peptide and its intracellular messenger cyclic adenosine monophosphate in serial samples of internal jugular blood taken from migraine pati...Objective. - To investigate changes in the levels of calcitonin gene- related peptide and its intracellular messenger cyclic adenosine monophosphate in serial samples of internal jugular blood taken from migraine patients without aura assessed during attacks, and to assess their relationship with the levels of IL- 8, MCP- 1, and RANTES in the same samples. Background. - Calcitonin gene- related peptide, the marker of trigeminovascular activation, is released in both the internal and external jugular venous blood of migraine patients during attacks. Experimental evidence demonstrated that when released from C- type sensory neurons in inflammatory pain models, it differentially induced expression of neutrophil chemotactic chemokine IL- 8, but not monocyte chemotactic chemokine MCP- 1 or lymphocyte chemotactic chemokine RANTES. These chemokines were never investigated in migraine. Design/Methods. - Eight migraine without aura patients were admitted to the hospital during the attacks. Internal jugular venous blood samples were taken immediately after catheter insertion, at the 1st, 2nd, and 4th hours after attack onset, and within 2 hours from its cessation. The levels of the sensory neuropeptide calcitonin gene- related peptide and the messenger cyclic adenosine monophosphate were measured by RIA method, and those of IL- 8, MCP- 1,and RANTES were measured by ELISA method. Results. - Higher calcitonin gene- related peptide levels were found in the internal jugular venous blood of migraine without aura patients compared with the time of catheter insertion (ANOVA: P < .0001) with a peak at the first hour (52.6 ± 9.2 ng/mL). A transient increase in IL- 8 was observed at the 2nd and 4th hours (P < .01 and P < .002, respectively), whereas no changes in the levels of MCP- 1 and RANTES were found at any time of the study. The increase in IL- 8 was accompanied by a parallel increase in cyclic adenosine monophosphate. Conclusions. - The present study confirms previous findings of an increase in calcitonin gene- related peptide in internal jugular venousblood of migraine without aura patients during attacks. The transient increase in the levels of IL- 8 concurs with the results of recent experimental research showing a calcitonin gene- related peptide- induced activation of IL- 8 gene expression, but not RANTES and MCP- 1, via the transcriptional factor AP- 2, which mediates transduction in response to cyclic adenosine monophosphate. Although IL- 8 is transiently increased during migraine attacks, an accumulation of leukocytes secondary to neurogenic inflammation is unlikely, as it is for other inflammatory events, because they are self limiting. Other events, including nitric oxide production, may contribute to counteract meningeal transvascular leukocyte migration during migraine attacks, as suggested by the model of sterile inflammation.展开更多
0 引言 急性颅脑损伤后(acute head injures,AHI)患者的脑脊液及血清乳酸值升高,可作为颅脑损伤严重程度和预后的判断依据,而出现脑内迟发血肿患者,其乳酸含量变化的特点,目前尚无相关报道。本研究拟通过观察急性颅脑损伤患者出现脑内...0 引言 急性颅脑损伤后(acute head injures,AHI)患者的脑脊液及血清乳酸值升高,可作为颅脑损伤严重程度和预后的判断依据,而出现脑内迟发血肿患者,其乳酸含量变化的特点,目前尚无相关报道。本研究拟通过观察急性颅脑损伤患者出现脑内迟发血肿前后颈静脉血清乳酸含量的变化,以探讨脑内迟发血肿患者血清乳酸含量变化的意义。展开更多
文摘Objective. - To investigate changes in the levels of calcitonin gene- related peptide and its intracellular messenger cyclic adenosine monophosphate in serial samples of internal jugular blood taken from migraine patients without aura assessed during attacks, and to assess their relationship with the levels of IL- 8, MCP- 1, and RANTES in the same samples. Background. - Calcitonin gene- related peptide, the marker of trigeminovascular activation, is released in both the internal and external jugular venous blood of migraine patients during attacks. Experimental evidence demonstrated that when released from C- type sensory neurons in inflammatory pain models, it differentially induced expression of neutrophil chemotactic chemokine IL- 8, but not monocyte chemotactic chemokine MCP- 1 or lymphocyte chemotactic chemokine RANTES. These chemokines were never investigated in migraine. Design/Methods. - Eight migraine without aura patients were admitted to the hospital during the attacks. Internal jugular venous blood samples were taken immediately after catheter insertion, at the 1st, 2nd, and 4th hours after attack onset, and within 2 hours from its cessation. The levels of the sensory neuropeptide calcitonin gene- related peptide and the messenger cyclic adenosine monophosphate were measured by RIA method, and those of IL- 8, MCP- 1,and RANTES were measured by ELISA method. Results. - Higher calcitonin gene- related peptide levels were found in the internal jugular venous blood of migraine without aura patients compared with the time of catheter insertion (ANOVA: P < .0001) with a peak at the first hour (52.6 ± 9.2 ng/mL). A transient increase in IL- 8 was observed at the 2nd and 4th hours (P < .01 and P < .002, respectively), whereas no changes in the levels of MCP- 1 and RANTES were found at any time of the study. The increase in IL- 8 was accompanied by a parallel increase in cyclic adenosine monophosphate. Conclusions. - The present study confirms previous findings of an increase in calcitonin gene- related peptide in internal jugular venousblood of migraine without aura patients during attacks. The transient increase in the levels of IL- 8 concurs with the results of recent experimental research showing a calcitonin gene- related peptide- induced activation of IL- 8 gene expression, but not RANTES and MCP- 1, via the transcriptional factor AP- 2, which mediates transduction in response to cyclic adenosine monophosphate. Although IL- 8 is transiently increased during migraine attacks, an accumulation of leukocytes secondary to neurogenic inflammation is unlikely, as it is for other inflammatory events, because they are self limiting. Other events, including nitric oxide production, may contribute to counteract meningeal transvascular leukocyte migration during migraine attacks, as suggested by the model of sterile inflammation.
文摘0 引言 急性颅脑损伤后(acute head injures,AHI)患者的脑脊液及血清乳酸值升高,可作为颅脑损伤严重程度和预后的判断依据,而出现脑内迟发血肿患者,其乳酸含量变化的特点,目前尚无相关报道。本研究拟通过观察急性颅脑损伤患者出现脑内迟发血肿前后颈静脉血清乳酸含量的变化,以探讨脑内迟发血肿患者血清乳酸含量变化的意义。
文摘目的探讨半坐位开颅患者无创脑氧饱和度(cerebral tissue oxygen saturation,SctO_(2))与颈静脉球部氧饱和度(jugular venous oxygen saturation,SjvO_(2))的影响因素。方法选取2018年4月至2020年5月首都医科大学宣武医院行半坐位听神经瘤手术的患者30例。采用Fore-sight近红外光仪监测无创SctO_(2),通过术侧颈静脉球部置管采集血液标本测定SjvO_(2)。记录半坐位切皮(T0)、硬脑膜剪开后30 min(T1)及肿瘤切除后(T2)双侧无创SctO_(2)及术侧SjvO_(2)、MAP、中心静脉压(central venous pressure,CVP)和颈静脉球部压力(jugular bulb pressure,JBP)。同时采集动脉血测定PaCO_(2)、PaO_(2),采集颈静脉球部血液标本测定颈静脉球部二氧化碳分压(pressure of carbon dioxide in the jugular venous,PjvCO_(2))、颈静脉球部氧分压(pressure of oxygen in the jugular venous,PjvO_(2))、红细胞比容(hematocrit,Hct)及乳酸(lactic acid,Lac),纳入MAP、CVP、JBP、PaCO_(2)、PaO_(2),PjvCO_(2)、PjvO_(2)、Hct及Lac进行SctO_(2)与SjvO_(2)影响因素的多元线性回归分析。结果PjvO_(2)、PjvCO_(2)、PaCO_(2)、JBP和Hct对SjvO_(2)的影响有统计学意义(P<0.05),调整后的R2=0.845;CVP、MAP及PaCO_(2)对术侧SctO_(2)的影响有统计学意义(P=0.000),调整后的R2=0.371。结论半坐位开颅患者采用SctO_(2)和SjvO_(2)监测时需考虑不同的影响因素,采取相应措施有效改善脑氧供需平衡状态。
