CAJ | 학술논문

目的探讨蛛网膜下腔出血(SAH)后大鼠血、脑脊液不对称二甲基精氨酸(ADMA)的浓度变化及其与一氧化氮(NO)浓度和脑血管痉挛(CVS)的关系.方法将78只SD大鼠分为对照组(n=6)、假手术组(n=36)及SAH组(n=36),采用枕大池二次注血法建立SAH动物模型.定期检测各亚组血浆、脑脊液中ADMA、NO浓度;显微镜下测量基底动脉壁厚度及动脉内径.结果 (1)SAH组脑脊液ADMA浓度逐渐升高,至术后5d达其最高值;NO浓度逐渐降低,至术后5d达其最低值;(2)以基底动脉壁厚度与内径的比值作为评价CVS程度的指标并进行Pearson相关性分析,SAH组脑脊液ADMA浓度与CVS程度呈正相关;与脑脊液NO浓度呈负相关.(3) SAH组血浆ADMA浓度无明显变化.结论 ADMA可能通过抑制NO生成影响SAH大鼠CVS的发生与发展;脑脊液ADMA水平与SAH大鼠CVS程度明显相关,可作为预测CVS的指标;血浆ADMA水平与CVS程度无明显相关.
목적 탐토주망막하강출혈(SAH)후대서혈、뇌척액불대칭이갑기정안산(ADMA)적농도변화급기여일양화담(NO)농도화뇌혈관경련(CVS)적관계.방법 장78지SD대서분위대조조(n=6)、가수술조(n=36)급SAH조(n=36),채용침대지이차주혈법건립SAH동물모형.정기검측각아조혈장、뇌척액중ADMA、NO농도;현미경하측량기저동맥벽후도급동맥내경.결과 (1)SAH조뇌척액ADMA농도축점승고,지술후5d체기최고치;NO농도축점강저,지술후5d체기최저치;(2)이기저동맥벽후도여내경적비치작위평개CVS정도적지표병진행Pearson상관성분석,SAH조뇌척액ADMA농도여CVS정도정정상관;여뇌척액NO농도정부상관.(3) SAH조혈장ADMA농도무명현변화.결론 ADMA가능통과억제NO생성영향SAH대서CVS적발생여발전;뇌척액ADMA수평여SAH대서CVS정도명현상관,가작위예측CVS적지표;혈장ADMA수평여CVS정도무명현상관.
Objective To investigate the correlation between asymmetric dimethylarginine (ADMA) and cerebral vasospasm (CVS) secondary to subarachnoid hemorrhage (SAH).Methods Seventy-eight healthy male adult Sprague-Dawley rats were randomly allocated into control group (n =6),sham group (n =36) and SAH group (n =36).In SAH group,a SAH model was established by double autologous blood injection into cisterna magna.Arterial blood,cerebrospinal fluid (CSF) and basilar artery samples of each group were collected at the preconcerted time.ADMA levels in the plasma and CSF samples were assessed using enzyme-linked immuno sorbent assay (ELISA).Nitrite and nitrate concentrations were used as a marker of nitric oxide production in plasma and CSF samples and determined by using nitrate reductase method.Pathomorphological changes were observed with optical microscope and inner diameter of basilar artery was measured by Micrometer after hematoxylin-eosin staining was performed.Results (1) In SAH group,ADMA levels in CSF samples were significantly increased at 1st,3rd,5th and 7th day (P ＜0.05),and NO levels in CSF samples were significantly decreased at 3rd,5th,and 7th day as compared with sham group (P＜0.01).(2) The ratio of thickness and inner diameter of basilar artery was used to indicate the degree of CVS.The level of ADMA in CSF samples was strongly correlated with the degree of CVS (r =0.641,P ＜0.01).Nitrite levels in CSF samples were negatively correlated with ADMA levels in CSF samples (r =-0.687,P ＜0.01).(3) Plasma ADMA levels in sham group and SAH group were similar and remained essentially unchanged during the several days after SAH.Plasma ADMA levels were neither correlated with NO levels (r =0.019,P ＞ 0.05) nor with the degree of vasospasm (r =-0.046,P ＞ 0.05).Conclusion Asymmetric dimethylarginine reduces the level of nitric oxide in CSF by inhibiting nitric oxide synthase and may be involved in the progression of cerebral vasospasm.The level of ADMA in CSF samples was strongly correlated with the degree of CVS in SAH rats.There is no evident correlation between the level of ADMA in plasma and the degree of CVS.