脑出血患者血浆去甲肾上腺素、乙酰胆碱与自主神经功能障碍的相关性研究鲁远君1 贺传沙1 文治成1 费容1 潘乙年2

The study on association between autonomic dysfunction and the level of plasma norepineprine and acetylcholine in acute phase of cerebral hemorrhag

摘要:

目的 研究脑出血患者急性期血浆去甲肾上腺素(norepineprine,NE)、乙酰胆碱(acetylcholine,Ach)的水平与自主神经功能障碍的研究；方法 分析45例不同部位初发脑出血患者和38例健康人,分别在入院后第2天、10天清晨抽取患者空腹静脉血3ml于预冷的抗凝管中,4℃低温离心,取上清液置-70℃以下低温保存。分别采用液质联用法、酶联免疫吸附测定法测定脑出血组及对照组血浆NE及Ach水平；记录患者自主神经功能障碍的临床表现；采用美国国立卫生研究院卒中量表(NIHSS)对患者神经功能缺损程度进行评分；结果 脑出血组第2天,第10天血浆NE水平(1.71?0.25 ng/ml,1.53?0.26 ng/ml)明显高于对照组(0.54?0.13ng/ml),差异有统计学意义(P<0.01),而血浆乙酰胆碱水平(76.88?12.38 ng/l,71.75?12.73 ng/l)明显低于对照组(105.61?14.27ng/l),差异有统计学意义(P<0.01),脑出血组血浆NE,Ach水平第2天与第10天比较,差异无统计学意义(P>0.05)；脑出血组第10天NIHSS评分明显低于第2天,差异有统计学意义(P<0.01)；结论 脑出血患者急性期血浆NE水平明显升高、而血浆Ach水平明显降低,血浆NE及Ach水平的变化可能与自主神经功能障碍有关联。

Abstract:

Objective To study the association between autonomic dysfunction and the level of plasma norepineprine and acetylcholine in acute phase of cerebralhemorrhage patients.Methods To analyze 45 patients with initial cerebral hemorrhage in different sites and 38 healthy man.Fasting 3ml venous blood was taken and put in the anticoagulant tube precooled at the second and tenth days after admission. Centrifuged at 4 ℃, The supernatant was set below -70 ℃. To detect plasma norepineprine level with cerebral hemorrhage group and control group by liquid chromatography-mass spectrometry,and acetylcholine level by enzyme-linked immunosorbent assay;Recording autonomic dysfunction symptoms with patients;To evaluate cerebral infarction patients neurologic impairment by NIHSS.Results The level of plasma norepineprine