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目的 研究肾素 (RA)、血管紧张素Ⅱ (AⅡ )、醛固酮 (ALD)在不同部位、范围的急性脑血管病(ACVD)患者中的含量及其作用。方法 采用放射免疫法测定 2 36例ACVD患者及 6 3名正常对照者血浆RA、AⅡ、ALD含量。结果 不同部位ACVD患者血浆RA、AⅡ、ALD含量较正常对照组显著升高 (P <0 .0 1)。不同部位脑出血时 ,血浆RA、AⅡ、ALD含量比较呈丘脑 >基底节 >脑叶 ,有显著性差异 (P <0 .0 1)。不同部位急性脑梗死时 ,以大脑中动脉系梗死RA、AⅡ、ALD含量最高 ,与丘脑梗死组、基底节梗死组及脑叶梗死组比较有显著性差异 (P <0 .0 1～ 0 .0 5 ) ,而后 3组之间RA、AⅡ、ALD含量比较无显著性差异 (P >0 .0 5 )。ACVD不同病损范围 ,血浆RA、AⅡ、ALD含量随着脑损伤范围增大而增高。结论 肾素 血管紧张素 醛固酮系统(RAS)改变与不同部位、范围ACVD密切相关 ,测定血浆RA、AⅡ、ALD含量 ,对临床监测ACVD患者病情 ,判断预后及提高治疗效果有积极的意义
Objective To study the content and effect of renin (RA), angiotensin Ⅱ (AⅡ) and aldosterone (ALD) in patients with acute cerebrovascular disease (ACVD) at different sites and ranges. Methods Radioimmunoassay was used to determine the levels of plasma RA, AII and ALD in 236 ACVD patients and 63 normal controls. Results The plasma levels of RA, AII and ALD in different regions of patients with ACVD were significantly higher than those in normal controls (P <0.01). The levels of plasma RA, AII and ALD were significantly different in thalamic> basal ganglia> cerebral lobe at different sites of intracerebral hemorrhage (P <0.01). In different parts of acute cerebral infarction, the contents of RA, AⅡ and ALD were the highest in middle cerebral artery infarction group, and there was significant difference compared with thalamus infarction group, basal ganglia infarction group and cerebral infarction group (P <0.01-0.0). 0 5). There was no significant difference in RA, AⅡ and ALD between the three groups (P> 0.05). ACVD different lesions, plasma RA, A Ⅱ, ALD content increased with the extent of brain injury increased. Conclusions The changes of renin-angiotensin aldosterone system (RAS) are closely related to the different sites and ranges of ACVD. The determination of plasma RA, AII and ALD levels has a positive effect on the clinical monitoring of ACVD patients’ condition, prognosis and improvement of therapeutic effect