ENDOTHELIN CONCENTRATIONS IN PATIENTS WITH ANEURYSMAL SUBARACHNOID HEMORRHAGE - CORRELATION WITH CEREBRAL VASOSPASM, DELAYED ISCHEMIC NEUROLOGICAL DEFICITS, AND VOLUME OF HEMATOMA
ENDOTHELIN CONCENTRATIONS IN PATIENTS WITH ANEURYSMAL SUBARACHNOID HEMORRHAGE - CORRELATION WITH CEREBRAL VASOSPASM, DELAYED ISCHEMIC NEUROLOGICAL DEFICITS, AND VOLUME OF HEMATOMA
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DOI：
10.3171/jns.1995.82.1.0055
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发表时间：
1995-01-01
影响因子：
4.1
通讯作者：
STOLKE, D
中科院分区：
文献类型：
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作者：
SEIFERT, V;LOFFLER, BM;STOLKE, D
动态观察蛛网膜下腔出血（SAH）患者血浆和脑脊液（CSF）中内皮素（ET）-1、ET-3和大内皮素-1（big ET-1）的含量，并与无SAH患者血浆ET-1和正常人血浆ET-1进行比较。大ET-1是SAH患者脑脊液中的主要肽。老年患者脑脊液大ET-1、ET-1、ET-3浓度明显高于青年患者。在经颅多普勒超声和临床体征记录的伴有脑血管痉挛（CVS）的SAH患者中，CSF中的术后浓度保持在手术前测量的水平或高于手术前测量的水平。无CVS的SAH患者脑脊液中ET-1浓度随时间延长而降低，而CVS的发生与大ET-1、ET-1浓度的升高相一致。SAH伴CVS与不伴CVS患者血浆大ET-1和ET-1浓度的时间依赖性差异有统计学意义。通过计算机断层扫描检测到的基底池血肿体积可预测CSF中的脑脊液浓度。CVS与血浆β-内酰胺酶浓度无相关性。在CVS的发病机制与SAH和迄今报道的有争议的数据相关的可能作用的血管紧张素转换酶进行了讨论。
Plasma and cerebrospinal fluid (CSF) concentrations of endothelin (ET)-1, ET-3, and big ET-1 in patients with aneurysmal rupture were measured serially for 2 weeks after the onset of aneurysmal subarachnoid hemorrhage (SAH) and compared with levels of ETs in patients without SAH and the plasma concentrations of ETs in normal volunteers. Big ET-1 was the predominant peptide present in the CSF of SAH patients. The CSF concentrations of big ET-1, ET-1, and ET-3 were significantly higher in older patients than in younger patients. In SAH patients with cerebral vasospasm (CVS) documented by transcranial Doppler sonography and clinical signs, postoperative concentrations of ETs in the CSF remained at or were increased above levels measured before surgery. In SAH patients without CVS, the concentrations of ETs in the CSF decreased with time, whereas the time course of CVS coincided with the increase in concentrations of big ET-1 and ET-1. The temporal dependence of concentrations of big ET-1 and ET-1 in SAH patients with and without CVS were significantly different. The volume of hematoma in the basal cisterns as detected by computerized tomography was predictive of the concentrations of ETs in the CSF. Plasma concentrations of ETs were not correlated wtih CVS. The possible role of ETs in the pathogenesis of CVS associated with SAH and the controversial data reported to date are discussed.