文档介绍：颅底肿瘤术后血浆内皮素-1、降钙素基因相关肽的动态变化及其与脑血管痉挛的相关性
作者:梁鹏,潘亚文,徐高峰,董志强
【摘要】目的研究内皮素-1(endothelin-1, ET-1)、降钙素基因相关肽(calcitonin gene-related peptide, CGRP)在颅底肿瘤术后并发脑血管痉挛(cerebral vasospasm, CVS)时的动态变化水平,探讨其在CVS中的作用。方法根据是否合并CVS,将34例颅底肿瘤术后患者分为症状性脑血管痉挛组、无症状脑血管痉挛组和非痉挛组。采用放射免疫法测定34例颅底肿瘤患者术后不同时点血浆ET-1及CGRP的含量,同时行经颅多普勒(transcranial doppler, TCD)检查判定患者CVS情况。同期选择10例健康成人进行对照研究。结果①颅底肿瘤术后1 d内血浆ET-1开始升高,5-7 d达高峰,随后又逐步降低,14 d时接近正常水平;血浆CGRP术后3 d开始降低,7 d降到最低,随后又逐步升高,14 d时接近正常水平。②术后3组患者血浆ET-1水平均高于正常组,CGRP水平均低于正常组。③术后痉挛组血浆ET-1含量较非痉挛组明显增高(P<),症状性痉挛组高于无症状痉挛组(P<)。而CGRP含量痉挛组较非痉挛组明显降低(P<),症状性痉挛组低于无症状痉挛组(P<)。④术后5-7 d时CVS患者达最高峰,14 d又明显减少。⑤CVS与血浆ET-1水平变化呈明显正相关(r=, P=),与CGRP呈明显负相关(r=-, P=)。结论颅底肿瘤术后血浆ET-1升高及CGRP降低可能是引起CVS的重要因素,可作为术后CVS的一种预测指标。
【关键词】颅底肿瘤脑血管痉挛蛛网膜下腔出血内皮素-1 降钙素基因相关肽
ABSTRACT: Objective To study the changes of endothelin-1 (ET-1) and calcitonin gene-related peptide (CGRP) in plasma of cerebral vasospasm (CVS) after resection of skull base tumors and the effect of the two factors on cerebral vasospasm. Methods Totally 34 cases were divided into symptomatic cerebral vasospasm group, asymptomatic cerebral vasospasm group and nonvasospasm group after resection of skull base tumors. The blood specimens were obtained from the 34 patients on days 1, 3, 5, 7 and 14 after the resection. The concentration of ET-1 and CGRP was detected by radioimmunoassay; meanwhile, transcranial doppler was recorded. Another 10 normal adult served as control group. Results ① Concentration of ET-1 in plasma elevated from the 1st day after resection of skull base tumors, reaching peak levels on day 5 to day 7, then decreased gradually and nearly recoverd on day 14. Concentration of CGRP in plasma decreased from day 3 after resection of skull base tumors, with the lowest concentration on day 7, then increased gradually and recoverd on day 14.
② Concentration of ET-1 in plasma of the three groups was higher than that of normal adult group, while concentration of CGRP of t