血浆一氧化氮水平和脑血管反应性与进展性卒中的关系研究

颈内静脉再通,又避免肺栓塞发生。本文提示只要将微导管留置在患侧静脉窦内即可,溶栓的任务由随后的48~96h 持续微量接触性溶栓术完成,它有效规避了大量应用溶栓药物的问题,在达到同样疗效情况下更为安全。本文11例患者,包括病程较长的1例,均取得良好疗效。

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(20091225收稿)

论

著

血浆一氧化氮水平和脑血管反应性与进展性卒中的关系研究

彭忠兴

黄旭明

洪铭范余青云苏全喜张明兴桀骜

摘要!目的

探讨一氧化氮(N O )和脑血管反应性(CVR )与进展性卒中(SIP )的关系。方法

对发

病24h 内住院经头颅CT 和/或MR I 检查证实为大脑中动脉(M C A )供血区脑梗死患者,以斯堪的那维亚卒中量表(SSS)在住院72h 内评分较入院时下降2分以上者判定为S I P 患者,共50例;在住院72h 内评分较入院时不下降或下降小于2分者判定为非S IP 患者,共61例;以无脑梗死的体检者为正常对照组(52例)。采用硝酸还原酶法测定两组NO 血浆水平,采用经颅多普勒超声结合屏气试验获取屏气指数(B H I)以评价CVR 。结果

SIP 组NO 水平(40.15

4.73)显著低于非SIP 组(56.55

8.35)和对照组(65.5

7.40)(P <0.00l),

SIP 组B H I(1.01

0.26)低于对照组(1.41

0.34)和非SIP 组(1.18

0.30)(P <0.00l ),B H I 与NO 血浆水

平呈正相关(r =0.29,P =0.034)。结论S I P 患者的CVR 降低与NO 水平下降有相关性,CVR 的下降是

导致SIP 的危险因素之一,检测NO 水平和B H I 有助于预测SIP 发生的可能性,为临床治疗决策和预后判断具

有重要意义。

关键词!

进展性卒中;一氧化氮;脑血管反应性

中图分类号:R 734文献标识码:A 文章编号:1006351X (2010)04024404

P l a s m a level of n itr ic ox i de and cer ebrova scu l a r r eac ti v ity a re a ssoc ia ted w ith stroke i n pr ogr essi on PENG

Zhong xi ng ,HU A NG Xu m ing ,HONG M i ng fan ,

Y U Q i ng yun,

SU Qua n xi ,Z HA NG M i ng xi ng,JIE Ao .

Depart m ent of N eurology ,t he F i rstA ffiliated H osp iti a l ofGuang dong P har m aceuti ca lUniversity ,Guangzho u 510080,Ch i na

C or r espond i ng au thor :

HUAN G Xu m i ng ,Ema i:l hxu m i ng @139.co m

Abstra ct !

O b jective

To investi gate the relati onship of nitric o x i de (NO ),

cerebro vascu l a r reactivit y

(CVR )and stro ke i n progressio n (SIP ).M ethods W ith the Scandi navi an Stroke Scale (SSS)as a standard t hat

f y SI ,x y f T MR I S 5SI f NS I (6)T f f f (5)NO y y ,the score o pa tient decreased b 2poi nts or m ore with i n 72ho urs t o dia

g nose P we e a m i ned the pati ents whowere d i agnosed as m i ddle cerebral arter i n a rctio n w it

h head C and /or with

i n 24h .o 0pa tien ts we re diagnosed as P .And t he score o patient decreased less than 2points as P 1cases .he vol un teers were ree o cerebra l in arcti on as nor m al control group 2cases .P las m a l eve l s were assa ed b nitrate reductase we eva l uated