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背景:内皮素和降钙素基因相关肽的动态平衡在脑梗死发生发展的过程中有非常重要的作用和意义。目的:观察东菱克栓酶溶栓治疗对脑梗死后血浆内皮素及降钙素基因相关肽水平的影响。设计:随机对照实验。单位:解放军广州军区总医院老年病四科。材料:实验于解放军广州军区总医院老年病四科完成。选择普通级新西兰老龄兔15只,兔龄18-20个月,平均体质量(3.5±0.5)kg,雌雄不拘。方法:将15只兔子通过改良自体血栓法制备兔脑梗死模型,选模中死亡1只,余14只随机分为对照组和治疗组。治疗组于栓塞后2h耳缘静脉缓慢注入东菱克栓酶,对照组缓慢注入等量生理盐水。观察比较治疗组和对照组脑梗死前后血浆内皮素及降钙素基因相关肽浓度的变化。主要观察指标:术前1h,术后2h(注药前),术后6h(注药后4h)的内皮素及降钙素基因相关肽含量的变化。结果:纳入兔子15只,选模中死亡1只,其余14只兔子进入结果分析。治疗组和对照组兔急性脑梗死术后2h内皮素明显上升(P<0.05,P<0.01),术后6h出现回调下降(P<0.01,P<0.01),其中治疗组下降幅度大于对照组(P<0.01);两组急性脑梗死术后2h降钙素基因相关肽明显下降,术后6h出现回升,治疗组回升幅度大于对照组,但差异无统计学意义(P>0.05)。结论:脑梗死急性期机体对内皮素和降钙素基因相关肽的平衡失调存在自身调节机制,早期使用东菱克栓酶溶栓治疗可使内皮素回调幅度明显增加,这可能是其对脑缺血再灌注损伤的保护机制之一。
BACKGROUND: The dynamic balance of endothelin and calcitonin gene-related peptide plays a very important role in the development of cerebral infarction. OBJECTIVE: To observe the effect of Thrombolytic Therapy of Dong Ling Ke on the level of plasma endothelin and calcitonin gene related peptide after cerebral infarction. Design: Randomized controlled experiment. Unit: People’s Liberation Army General Hospital of Guangzhou Military Region Geriatrics four subjects. Materials: The experiment was completed in the four departments of geriatrics in Guangzhou Military Region General Hospital of People’s Liberation Army. A total of 15 New Zealand aged rabbits were selected, aged 18-20 months. The average body weight was (3.5 ± 0.5) kg, both male and female. Methods: Fifteen rabbits were prepared by modified autologous thrombosis in rabbits with cerebral infarction model. One of them died in the model selection. The other 14 rabbits were randomly divided into control group and treatment group. In the treatment group, Cucurbitacin was slowly infused into the ear marginal vein 2h after embolization, and the control group was slowly injected with the same amount of normal saline. The changes of plasma endothelin and calcitonin gene-related peptide concentrations in the treatment group and the control group before and after cerebral infarction were observed and compared. MAIN OUTCOME MEASURES: The changes of ET and CGRP levels at 1h before surgery, 2h after surgery (before drug injection) and 6h after drug injection (4h after drug injection). Results: Fifteen rabbits were included, one died in the model selection and the remaining 14 rabbits were involved in the result analysis. Endothelins were significantly increased 2h after operation in acute cerebral infarction group (P <0.05, P <0.01), and the callback decreased 6h after operation (P <0.01, P <0.01) (P <0.01). The level of calcitonin gene-related peptide decreased significantly at 2h after operation in both groups, and recovered at 6h after operation. The recovery rate in the treatment group was greater than that in the control group, but the difference was not statistically significant (P> 0.05). Conclusion: There is a mechanism of self-regulation in the imbalance of endothelin and calcitonin gene-related peptide in the acute stage of cerebral infarction. Early use of rhodolthrombolytic therapy could significantly increase the amplitude of endothelin withdrawal, which may be due to its effect on brain One of the protective mechanisms of ischemia-reperfusion injury.