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目的：对脑血管病（ＣＶＤ）患者进行不同病程、不同病变部位下丘脑垂体肾上腺（ＨＰＡ）机能改变的观察研究。方法：应用放免分析法，对１７２例ＣＶＤ患者（脑出血６８例、脑梗死１０４例）检测血清ＡＣＴＨ、皮质醇含量。结果：急性期ＣＶＤ患者血清ＡＣＴＨ、皮质醇含量水平明显高于对照组，尤以脑出血为著，差异均有显著性（Ｐ＜０．０５～０．０１）。恢复期时，其含量水平明显下降，但仍高于对照组，差异有显著性（Ｐ＜０．０５）。不同病变部位ＣＶＤ时，血清ＡＣＴＨ、皮质醇含量不同，呈现丘脑＞基底节＞脑叶的趋势。结论：ＣＶＤ时，随病程延长、病症好转，ＨＰＡ机能紊乱具有可逆性；不同部位ＣＶＤ时ＨＰＡ机能成应激性增强；脑组织病损后神经介质变化也可能为ＨＰＡ机能改变的重要因素。
Objective: To observe the changes of function of hypothalamic-pituitary-adrenal (H-P-A) in patients with cerebrovascular disease (CVD) at different stages and at different locations. Methods: Radioimmunoassay was used to detect serum ACTH and cortisol levels in 172 CVD patients (68 with cerebral hemorrhage and 104 with cerebral infarction). Results: The levels of serum ACTH and cortisol in patients with acute phase CVD were significantly higher than those in the control group, especially for cerebral hemorrhage (P <0.05 ~ 0.01). During convalescence, its content decreased significantly, but still higher than the control group, the difference was significant (P <0.05). Different lesions of CVD, serum ACTH, cortisol levels are different, showing the trend of thalamus> basal ganglia> lobar. Conclusions: With the prolongation of the course of the disease, the symptoms are improved and the dysfunction of HPA is reversible. The HPA function of the different parts of the brain is enhanced by stress, and the neurological changes may also be H P A major factor in the performance change.