Rejdak Konrad, Petzold Axel, Sharpe Martyn A, Kay Andrew D, Kerr Mary, Keir Geoff, Thompson Edward J, Giovannoni Gavin
Department Neuroinflammation, Institute of Neurology, Queen Square, London WC1N 3BG, UK.
J Neurol Sci. 2004 Apr 15;219(1-2):71-6. doi: 10.1016/j.jns.2003.12.011.
The findings of various studies reporting temporal changes in CSF total nitrite/nitrate (NOx) levels after subarachnoid hemorrhage (SAH) vary considerably. The study group comprised 10 patients with SAH and 10 control subjects. Total nitrite/nitrate concentration was measured by a vanadium-based assay with the colorimetric Griess reaction. CSF oxyhemoglobin level was assessed by spectrophotometry. After an initial peak (22.6+/-10.1 microM) within first 24 h after SAH, CSF NOx decreased gradually during the period of observation. There was a significant correlation between CSF concentrations of NOx and OxyHb in the entire observation period (R=0.87, p<0.001). When the impact of bleeding into CSF was considered, patients with very good outcome [Glasgow Outcome Scale (GOS)=5] had significantly lower CSF NOx (11.1+/-1.3 microM) than those with worse outcome (GOS<5) (21.8+/-11.2 microM, p<0.01). In conclusion, this study demonstrates that after aneurysm rupture CSF NOx levels correlate with OxyHb. We suggest this as a novel interpretation of other variable findings in relation to NO metabolites in the central nervous system (CNS) post SAH, and hence it could usefully be incorporated into the planning of future studies, correlating NOx with clinical outcome.
各项研究报告的蛛网膜下腔出血（SAH）后脑脊液中亚硝酸盐/硝酸盐（NOx）总量水平的时间变化结果差异很大。研究组包括10例SAH患者和10例对照受试者。采用基于钒的比色格里斯反应法测定亚硝酸盐/硝酸盐总量浓度。通过分光光度法评估脑脊液氧合血红蛋白水平。SAH后最初24小时内出现一个初始峰值（22.6±10.1微摩尔），之后在观察期内脑脊液NOx逐渐下降。在整个观察期内，脑脊液NOx浓度与氧合血红蛋白（OxyHb）之间存在显著相关性（R = 0.87，p < 0.001）。当考虑脑脊液内出血的影响时，预后非常好[格拉斯哥预后量表（GOS）= 5]的患者脑脊液NOx水平（11.1±1.3微摩尔）显著低于预后较差（GOS < 5）的患者（21.8±11.2微摩尔，p < 0.01）。总之，本研究表明动脉瘤破裂后脑脊液NOx水平与氧合血红蛋白相关。我们认为这是对SAH后中枢神经系统（CNS）中与NO代谢产物相关的其他不同研究结果的一种新解释，因此它可有效地纳入未来研究规划，将NOx与临床结局相关联。
