脑出血与蛛网膜下腔出血后β-内啡肽和促性腺激素释放激素水平变化研究

发布时间：2018-12-11 08:33

【摘要】：目的动态观察脑出血(ICH)及蛛网膜下腔出血(SAH)后β-内啡肽、促性腺激素释放激素(GnRH)水平,探讨ICH、SAH丘脑应激反应的差异。方法分别选取2014年5月—2016年5月于重庆市中医院神经外科住院的符合纳入标准的自发性ICH患者38例为ICH组,自发性SAH患者26例为SAH组。同期选取于本院行腰穿麻醉术的无神经系统疾病患者20例为对照组。分别检测并记录对照组患者入院时血浆、脑脊液中β-内啡肽、GnRH水平,ICH组、SAH组患者入院时及入院1、3、7、14、30 d血浆、脑脊液中β-内啡肽、GnRH水平。结果 ICH组根据剔除标准剔除18例,最终纳入20例;SAH组根据剔除标准剔除6例,最终纳入20例。ICH组、SAH组入院时及入院1、3、7、14、30 d血浆、脑脊液β-内啡肽水平高于对照组(P0.05);SAH组入院时及入院1、3、7、14、30d血浆、脑脊液β-内啡肽水平高于ICH组(P0.05)。ICH组、SAH组入院时及入院1、3、7、14、30 d血浆、脑脊液GnRH水平高于对照组(P0.05);SAH组入院时及入院1、3、7、14、30 d血浆、脑脊液GnRH水平高于ICH组(P0.05)。结论β-内啡肽和GnRH参与ICH、SAH下丘脑应激反应,ICH下丘脑应激反应比SAH轻,监测血液、脑脊液β-内啡肽、GnRH水平对脑损伤程度判定及预后评估有重要临床意义。
[Abstract]:Objective to observe dynamically the levels of 尾 -endorphin and gonadotropin releasing hormone (GnRH) after cerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) and to explore the difference of the stress response of ICH,SAH thalamus. Methods from May 2014 to May 2016, 38 patients with spontaneous ICH and 26 patients with spontaneous SAH in neurosurgery department of Chongqing traditional Chinese Medicine Hospital were selected as ICH group and SAH group respectively. At the same time, 20 patients without nervous system diseases undergoing lumbar anaesthesia in our hospital were selected as control group. The plasma levels of 尾 -endorphin and GnRH in cerebrospinal fluid (CSF), the plasma levels of 尾 -endorphin and GnRH in cerebrospinal fluid (CSF) were measured at admission and 30 days after admission in ICH group and SAH group, respectively. Results in the ICH group, 18 cases were excluded according to the exclusion criteria, and 20 cases were included. In the SAH group, 6 cases were excluded according to the exclusion criteria, and 20 cases were included. The plasma levels of 尾 -endorphin in the ICH group, SAH group and the control group were significantly higher than those in the control group (P0.05). The levels of 尾 -endorphin in cerebrospinal fluid (CSF) in SAH group were higher than those in ICH group (P0.05) on admission and 30 days after admission (P0.05). The level of GnRH in cerebrospinal fluid (CSF) was higher than that in control group (P0.05). The level of GnRH in cerebrospinal fluid (CSF) of SAH group was higher than that of ICH group (P0.05). Conclusion 尾 -endorphin and GnRH are involved in the stress response of hypothalamus in ICH,SAH. The stress response of hypothalamus in ICH is lighter than that in SAH. Monitoring the levels of 尾 -endorphin and GnRH in blood and cerebrospinal fluid is of great clinical significance in judging the degree of brain injury and evaluating the prognosis.
【作者单位】：重庆市中医院重庆市中医研究院神经外科;
【基金】：第三军医大学2015年度“创伤、烧伤与复合伤国家重点实验室开放基金”资助项目(SKLKF201505) 重庆市中医院院内培育课题(2014-2-22)
【分类号】：R743.3

【相似文献】