国际脑血管病杂志
國際腦血管病雜誌
국제뇌혈관병잡지
INTERNATIONAL JOURNAL OF CEREBROVASCULAR DISEASES
2008年
2期
117-120
,共4页
于占彩%李振光%伍期专%丛海铭%苘红好%蒋东晓%李霞%孙新虎%迟相林%唐朝枢
于佔綵%李振光%伍期專%叢海銘%苘紅好%蔣東曉%李霞%孫新虎%遲相林%唐朝樞
우점채%리진광%오기전%총해명%경홍호%장동효%리하%손신호%지상림%당조추
溶血磷脂酸%蛛网膜下腔出血%脑血管痉挛
溶血燐脂痠%蛛網膜下腔齣血%腦血管痙攣
용혈린지산%주망막하강출혈%뇌혈관경련
subarachnoid hemorrhage%cerebral vasospasm%lysophosphatidic acid
目的:观察蛛网膜下腔出血(SAH)患者脑脊液溶血磷脂酸(LPA)含量动态变化的特点及其与脑血管痉挛(CVS)的关系,探索CVS的发病机制.方法:选取经临床和辅助检查确诊的SAH患者67例,分别于发病后24 h、7 d、14 d和28 d测定脑脊液LPA含量,并与对照组进行比较,同时观察LPA含量与CVS在时程上的相关性.结果:67例SAH患者中共有29例(43.3%)发生CVS,平均发生时间为6.6 d.发病24 h时,SAH患者脑脊液LPA含量与对照组无显著差异;发病7 d时显著高于对照组(P＜0.001);发病14 d时显著高于对照组(P＜0.01),但显著低于发病7 d时(P＜0.01);发病28 d时降至基线水平,与对照组无显著差异.发病24 h时,CVS组脑脊液LPA含量与无CVS组无显著差异,发病7 d时显著高于无CVs组(P＜0.001),发病14 d时仍显著高于无CVS组(P＜0.01);发病28 d时两组之间无显著差异.结论:SAH患者脑脊液LPA水平在发病后7～14 d显著升高,并且在时程上与CVS发生显著关联.检测脑脊液12A含量对预测CVS的发生可能具有重要意义.
目的:觀察蛛網膜下腔齣血(SAH)患者腦脊液溶血燐脂痠(LPA)含量動態變化的特點及其與腦血管痙攣(CVS)的關繫,探索CVS的髮病機製.方法:選取經臨床和輔助檢查確診的SAH患者67例,分彆于髮病後24 h、7 d、14 d和28 d測定腦脊液LPA含量,併與對照組進行比較,同時觀察LPA含量與CVS在時程上的相關性.結果:67例SAH患者中共有29例(43.3%)髮生CVS,平均髮生時間為6.6 d.髮病24 h時,SAH患者腦脊液LPA含量與對照組無顯著差異;髮病7 d時顯著高于對照組(P＜0.001);髮病14 d時顯著高于對照組(P＜0.01),但顯著低于髮病7 d時(P＜0.01);髮病28 d時降至基線水平,與對照組無顯著差異.髮病24 h時,CVS組腦脊液LPA含量與無CVS組無顯著差異,髮病7 d時顯著高于無CVs組(P＜0.001),髮病14 d時仍顯著高于無CVS組(P＜0.01);髮病28 d時兩組之間無顯著差異.結論:SAH患者腦脊液LPA水平在髮病後7～14 d顯著升高,併且在時程上與CVS髮生顯著關聯.檢測腦脊液12A含量對預測CVS的髮生可能具有重要意義.
목적:관찰주망막하강출혈(SAH)환자뇌척액용혈린지산(LPA)함량동태변화적특점급기여뇌혈관경련(CVS)적관계,탐색CVS적발병궤제.방법:선취경림상화보조검사학진적SAH환자67례,분별우발병후24 h、7 d、14 d화28 d측정뇌척액LPA함량,병여대조조진행비교,동시관찰LPA함량여CVS재시정상적상관성.결과:67례SAH환자중공유29례(43.3%)발생CVS,평균발생시간위6.6 d.발병24 h시,SAH환자뇌척액LPA함량여대조조무현저차이;발병7 d시현저고우대조조(P＜0.001);발병14 d시현저고우대조조(P＜0.01),단현저저우발병7 d시(P＜0.01);발병28 d시강지기선수평,여대조조무현저차이.발병24 h시,CVS조뇌척액LPA함량여무CVS조무현저차이,발병7 d시현저고우무CVs조(P＜0.001),발병14 d시잉현저고우무CVS조(P＜0.01);발병28 d시량조지간무현저차이.결론:SAH환자뇌척액LPA수평재발병후7～14 d현저승고,병차재시정상여CVS발생현저관련.검측뇌척액12A함량대예측CVS적발생가능구유중요의의.
Objective: To observe the characteristics of dynamic changes of lysophosphatidic acid (LPA) levels in cerebrospinal fluid (CSF) in patients with subarachnoid hemorrhage (SAH) and its relationship with cerebral vasospasm (CVS) and to explore the pathogenesis of CVS. Methods: Sixty-seven patients with SAH diagnozed by clinical and accessory examinations were selected. The LPA levels in CSF were measured at 24 hours, day 7,14, and 28 respectively after the onset of symptoms,and they were compared with a control group. The correlation between LPA levels and CVS on the time course was also observed at the same time. Results: Of the 67 patients with SAH, a total of 29 patients (43.3%) occurred CVS, the average time of occurrence was 6. 6 days. There was no significant difference between the LPA levels in CSF in patients with SAH and the control group at 24 hours after the onset of symptoms; they were significantly higher than the control group at day 7 (P ＜0. 001); they were significantly higher than the control group at day 14 (P ＜ 0. 001), but they were significantly lower than those at day 7 (P ＜ 0. 01); they decreased to baseline at day 28, and there was significant difference compared with the control group. There was no significant difference between the LPA levels in the CVS group and those in the non-CVS group at 24 hours, they were significantly higher than those in the non-CVS group at day 7 (P ＜0. 001), they were still significantly higher than those in the non-CVS group at day 14 (P ＜0. 01); and there was no significant difference between the 2 groups at day 28. Conclusions: The LPA levels in CSF in patients with SAH increased significantly from day 7 to day 14 after the onset of symptoms, and they had obvious association with CVS on the time course. The detection of the LPA levels in CSF may have important significance in predicting the occurrence of CVS.
