Kessler Iruena Moraes, Pacheco Yolanda Galindo, Lozzi Silene Paulino, de Araújo Antônio Santos, Onishi Franz Jooji, de Mello Paulo Andrade
Neurosurgical Service, Medical School, University of Brasilia, 71680-070 Brasília-DF, Brazil.
Surg Neurol. 2005;64 Suppl 1:S1:2-5; discussion S1:5. doi: 10.1016/j.surneu.2005.04.014.
Plasma and cerebrospinal fluid (CSF) concentrations of endothelin-1 (ET-1) were measured in patients with subarachnoid hemorrhage (SAH) after aneurysmal rupture and compared with levels of ET-1 in volunteers. We analyze the relationship between levels of ET-1 in both CSF and plasma with the risk of developing cerebral vasospasm (CVS).
Cerebrospinal fluid and blood samples were collected from 30 selected patients after SAH and from 10 healthy volunteers who were used as control. All samples were stored at -70 degrees C and the levels of ET-1 in CSF and blood were measured by using enzyme-linked immunosorbent assay and Western blot. All patients were submitted to angiography to confirm vasospasm.
From the 30 patients admitted at different days of SAH, 18 (60%) developed clinical CVS and 10 (33%) presented angiographic CVS. The levels of ET-1 in the CSF were significantly higher (P = .0001) in patients (1.618 +/- 1.05 fmol/mL) than in controls (0.365 +/- 0.328 fmol/mL). There was statistical difference (P < .05) in CSF levels of ET-1 between each group of the Hunt-Hess scale and controls. The mean plasma concentration of ET-1 was similar (P > .05) in the control group (1.531 +/- 0.753 fmol/mL) and in patients with SAH (1.920 +/- 1.15 fmol/mL).
These findings indicate that a significant rise in ET-1 levels in the CSF, but not in the plasma, occurs in patients who develop CVS after SAH. Our observation suggests that ET-1 might be involved in the pathogenesis of SAH-associated CVS.
测量动脉瘤破裂后蛛网膜下腔出血（SAH）患者血浆和脑脊液（CSF）中内皮素-1（ET-1）的浓度，并与志愿者的ET-1水平进行比较。我们分析脑脊液和血浆中ET-1水平与发生脑血管痉挛（CVS）风险之间的关系。
从30例选定的SAH患者和10名健康志愿者（作为对照）中采集脑脊液和血液样本。所有样本均储存在-70℃，采用酶联免疫吸附测定法和蛋白质印迹法测量脑脊液和血液中ET-1的水平。所有患者均接受血管造影以确认血管痉挛。
在SAH不同日期入院的30例患者中，18例（60%）发生临床CVS，10例（33%）出现血管造影CVS。患者脑脊液中ET-1水平（1.618±1.05 fmol/mL）显著高于对照组（0.365±0.328 fmol/mL）（P = 0.0001）。Hunt-Hess分级每组与对照组之间脑脊液ET-1水平存在统计学差异（P < 0.05）。对照组血浆ET-1平均浓度（1.531±0.753 fmol/mL）与SAH患者（1.920±1.15 fmol/mL）相似（P > 0.05）。
这些发现表明，SAH后发生CVS的患者脑脊液中ET-1水平显著升高，但血浆中未升高。我们的观察结果表明，ET-1可能参与SAH相关性CVS的发病机制。
