Duration of glutamate release after acute ischemic stroke
Duration of glutamate release after acute ischemic stroke
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DOI：
10.1161/01.str.28.4.708
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发表时间：
1997-04-01
期刊：
影响因子：
8.3
通讯作者：
Noya, M
中科院分区：
文献类型：
--
作者：
Davalos, A;Castillo, J;Noya, M
背景和目的急性缺血性脑卒中患者血浆和脑脊液（CSF）中谷氨酸水平升高。尚未研究这种兴奋性氨基酸释放的持续时间，因此，谷氨酸拮抗剂治疗的机会窗口未知。方法采用高效液相色谱法测定184例病程<24 h的急性脑梗死患者和43例对照组脑脊液中谷氨酸含量。在症状发作后6至24小时内研究的患者中，谷氨酸水平中位数显著低于前6小时内研究的患者，并在对照组的参考范围内（3 [范围，2至10]与5 μ mol/L [范围，2至17]; P < .0001）。在64例进展性缺血性中风，谷氨酸浓度测定在任何时间间隔在发病后的第一个24小时内显着高于稳定的中风和对照groups.Conclusions谷氨酸增加的CSF中的存在不能被记录超过6小时在稳定的缺血性中风。在进展性卒中中观察到的谷氨酸持续升高表明，预防神经功能恶化的窗口可能更宽。
Background and Purpose High levels of glutamate in plasma and cerebrospinal fluid (CSF) have been demonstrated in patients with acute ischemic stroke. The duration of this excitatory amino acid release has not been studied, and therefore the window of opportunity of treatment with glutamate antagonists is unknown. The aim of this investigation was to study the duration of the glutamate increase in patients with stable and progressing ischemic stroke.Methods Glutamate in CSF was measured by high-performance liquid chromatography in 184 patients with an acute cerebral infarction of less than 24 hours' duration and in 43 control subjects,Results Among the 120 patients with stable ischemic stroke, median glutamate levels were significantly lower-and within the reference range of control subjects-in those patients studied 6 to 24 hours from onset of symptoms than in patients studied in the first 6 hours (3 [range, 2 to 10] versus 5 mu mol/L [range, 2 to 17]; P < .0001). In 64 patients with progressing ischemic stroke, glutamate concentrations measured at any time interval during the first 24 hours from onset were significantly higher than in the stable stroke and control groups.Conclusions The presence of glutamate increase in the CSF cannot be documented for greater than 6 hours in stable ischemic stroke. The sustained elevation of glutamate observed in progressing stroke suggests that the window to prevent neurological deterioration may be wider.