【摘要】 背景:曾经有研究认为蛛网膜下腔出血(subarachnoidhemorrhage,SAH)后继发脑血管痉挛就是脑脊液中神经肽Y含量增高所致。关于脑脊液中神经肽Y增高的来源及机制目前尚不清楚。目的:探讨神经肽类物质在SAH后脑血管痉挛中的作用机制,为寻找有效的防治脑血管痉挛的方法奠定一定的理论基础。设计:完全随机设计,对照实验研究。地点和材料:研究地点为哈尔滨医科大学附属二院神经科,材料为由黑龙江兽医研究所提供Wister雄性大鼠20只,体质量250～300g。方法:20只Wistar大鼠被随机分为正常对照组及单纯注血组,并通过“枕小脑延髓池注血法”建立SAH模型,根据临床症状和体征及皮质脑血流量的变化来判定脑血管痉挛的程度。主要观察指标:采用放射免疫法动态观察实验性大鼠SAH后脑血管痉挛血浆、脑脊液中神经肽Y、心钠素含量的变化。结果:对照组与注血组皮质脑血流量的变化,注血组低于对照组,差异有显著性意义(P<0.01),组内比较,SAH各时限点,均显著低于SAH前。注血组血浆、脑脊液中神经肽Y、心钠素含量明显高于同期正常对照组(P<0.01)。注血组较同期正常对照组血浆、脑脊液中神经肽Y含量增高明显(P<0.01);注血组在注血后30min开始升高,至第7d达到高峰,各组内比较差异有显著性意义(P<0.01)。注血组在注血后第2d、第4d、第更多还原

【Abstract】 BACKGROUND:As believed by some researches,cerebral vasospasm (CVS) following s ubarachnoid hemorrhage(SHA) was caused by the increase of neuropeptide Y in cere brospinal fluid(CSF). However,the origin and the mechanism of the increase of ne uropeptide Y in CSF are still unclear. OBJECTIVE:To discuss the mechanism of neuropeptide in CVS following SAH for pr oviding a theoretical foundation in looking for an effective method in the preve ntion and therapy of CVS. DESIGN:A completely randomized controlled study. SETTING and MATERIALS:The study was completed in Neurology Department of the S econd Affiliated Hospital of Harbin Medical University.Twenty male Wister rats w ith a body weight from 250 to 300 g were obtained from Heilongjiang Veterinary I nstitution. METHODS:Twenty rats were randomly allocated into control and blood-infusion g roups.SAH model was established through foramen magnum infusion.The degree of CV S was determined based on clinical symptoms and signs,and the changes of blood f low in cerebral cortex. MAIN OUTCOME MEASURES:The changes of contents of serum and CSF neuropeptide Y and atrial natriuretic factor(ANF) after SAH in rats were dynamically observed t hrough radioimmunology. RESULTS:The blood flow in the blood-infusion group was significantly lower th an that of control group(P< 0.01).The blood flows at different period within blo od-infusion group were distinctly lower compared with that before SAH.The conte nts of serum and CSF neuropeptide Y and ANF in the blood-infusion group were si gnificantly higher than those of the control group at the corresponding period(P < 0.01).The contents of serum and CSF neuropeptide Y significantly increased in the blood-infusion group as compared with the control group at the correspondin g period(P< 0.01),which increased since 30 minutes after blood infusion and reac hed its peak at the 7th day.The differences between the two groups were signific ant(P< 0.01).The contents of serum and CSF ANF gradually increased on the 2nd, 4 th and 7th day in the blood-infusion group,which significantly higher than thos e of the control group at the corresponding period(P< 0.01). CONCLUSION:the contents of serum and CSF neuropeptide Y and ANF increase after CVS.Neuropeptide Y is one of the important vascular active substances in CVS fo llowing SAH.更多还原