Changes in the expression of vasoconstrictors in cerebrospinal fluid from patients with subarachnoid hemorrhage

doi:10.3969/j.issn.1672-6731.2020.06.013

Abstract

Abstract:

Background Cerebral vasospasm (CVS) is one of the common severe complications in patients with subarachnoid hemorrhage (SAH), as well as an independent risk factor for poor prognosis. As previous studies showed, CVS is closely related to the changes in the expression of vasoconstrictors in cerebrospinal fluid (CSF). In the present study, we measured the levels of endothelin-1 (ET-1), angiotensin Ⅱ (Ang Ⅱ) and thromboxane B₂ (TXB₂) in SAH patients' CSF to demonstrate the relationship with CVS. Methods A total of 18 patients with SAH were enrolled from September 2018 to January 2019. CSF samples were collected within 3 d, 3-5 d, > 5-7 d, > 7-d and ≥ 10 d after SAH. The levels of ET-1, Ang Ⅱ and TXB₂ were detected by enzyme-linked immune sorbent assay (ELISA). Results The levels of Ang Ⅱ (P=0.041) and TXB₂ (P=0.050) in CSF at different time points were significantly different. The level of AngⅡ at ≥ 10 d after SAH was significantly lower than that at < 3 d (P=0.009) and > 5-7 d (P=0.000) after SAH. The level of TXB₂ reached the peak at > 5-7 d after SAH (P=0.036, 0.008), and then gradually decreased without significance. The level of ET-1 in CSF at different time points were not different (P>0.05, for all). Conclusions The levels of Ang Ⅱ and TXB₂ in SAH patients' CSF present dynamic variation with the progression of the disease. This may be involved in the occurrence of CVS.

Key words: Subarachnoid hemorrhage, Cerebrospinal fluid, Vasospasm,intracranial, Endothelin-1, AngiotensinⅡ, Thromboxane B₂

摘要：

研究背景 脑血管痉挛是蛛网膜下腔出血最为常见的严重并发症之一，是引起预后不良的主要危险因素，与脑脊液血管收缩因子表达变化密切相关。本研究对蛛网膜下腔出血患者脑脊液内皮素-1（ET-1）、血管紧张素Ⅱ（AngⅡ）和血栓素B₂（TXB₂）表达水平进行检测，探讨其与脑血管痉挛间的关系。方法纳入2018年9月至2019年1月共18例蛛网膜下腔出血患者，分别于发病后<3 d（10例）、3~5 d（8例）、>5~7 d（9例）、>7~d（7例）和≥10 d（6例）采集脑脊液标本，采用酶联免疫吸附试验测定ET-1、AngⅡ和TXB₂水平。结果蛛网膜下腔出血后，各时间点脑脊液AngⅡ（P=0.041）和TXB₂（P=0.050）水平差异有统计学意义，其中AngⅡ至发病≥10 d显著降低，并低于发病后<3 d（P=0.009）和发病后>5~7 d（P=0.000），TXB₂至发病后> 5~7 d达峰值（P=0.036，0.008），此后逐渐下降，但与峰值水平差异无统计学意义（均P>0.05）；而ET-1水平不同观察时间点差异无统计学意义（P>0.05）。结论蛛网膜下腔出血患者脑脊液AngⅡ和TXB₂表达随疾病进展呈现动态变化，可能与脑血管痉挛的发生发展密切相关。

关键词: 蛛网膜下腔出血, 脑脊髓液, 血管痉挛, 颅内, 内皮缩血管肽1, 血管紧张素Ⅱ, 血栓烷B₂

CHENG Ya-wen, GUO Yi-chen, AN Jia-qi, XU Gao-feng, JIA Rui, DENG Yong-ning, LUO Guo-gang. Changes in the expression of vasoconstrictors in cerebrospinal fluid from patients with subarachnoid hemorrhage[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2020, 20(6): 546-550.

程娅雯, 郭益辰, 安佳琪, 徐高峰, 贾蕊, 邓永宁, 罗国刚. 蛛网膜下腔出血患者脑脊液血管收缩因子表达变化[J]. 中国现代神经疾病杂志, 2020, 20(6): 546-550.

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https://journal11.magtechjournal.com/cjcnn/EN/Y2020/V20/I6/546

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