Edvinsson L, Uddman R, Juul R
Department of Internal Medicine, University Hospital, Lund, Sweden.
Neurosurg Rev. 1990;13(4):265-72. doi: 10.1007/BF00346363.
The present paper reviews recent studies in monkey and man adding further to understanding of the role of perivascular peptides in the pathophysiology of subarachnoid haemorrhage. 1. The perivascular fibers, sympathetic fibers (storing noradrenaline, neuropeptide Y), parasympathetic fibers (storing acetylcholine, vasoactive intestinal peptide, peptide histidine methionine and neuropeptide Y) and sensory fibers (storing tachykinins, calcitonin gene-related peptide) were traced using True Blue in monkey. 2. Tracing studies of the monkey middle-cerebral artery (MCA) innervation confirmed earlier studies in rats and cats, with superior cervical and trigeminal ganglia as main immunostaining areas, and contralateral involvement in the superior cervical and trigeminal ganglia. Sphenopalatine immunostaining was scarce. 3. The release of neuropeptides in the external jugular vein in humans in the postoperative course after subarachnoid hemorrhage, using radioimmunoassay, was correlated to hemodynamical changes (vasoconstriction) monitored with Doppler ultrasound on middle cerebral (MCA) and internal carotid arteries (ICA)). 4. Neuropeptide Y-like immunoreactivity (NPY-LI) levels were increased compared to controls in patients with hemodynamic changes, and in some patients a relationship was found between velocities and NPY-LI. 5. Calcitonin gene-related peptide-LI levels were also increased in connection with vasospasm. In patients with MCA lesions a correlation of 0.61, p = 0.0002 was found between hemodynamic index (V MCA/V ICA) and CGRP-LI. The possible sympathetic and trigemino-cerebrovascular activation are discussed.
本文综述了近期在猴子和人类身上开展的研究，这些研究进一步增进了我们对血管周围肽在蛛网膜下腔出血病理生理学中作用的理解。1. 使用真蓝对猴子的血管周围纤维、交感神经纤维（储存去甲肾上腺素、神经肽Y）、副交感神经纤维（储存乙酰胆碱、血管活性肠肽、肽组氨酸蛋氨酸和神经肽Y）以及感觉纤维（储存速激肽、降钙素基因相关肽）进行了追踪。2. 对猴子大脑中动脉（MCA）神经支配的追踪研究证实了早期在大鼠和猫身上开展的研究结果，即颈上神经节和三叉神经节是主要的免疫染色区域，且对侧颈上神经节和三叉神经节也有累及。蝶腭神经节的免疫染色较少。3. 在蛛网膜下腔出血后的术后过程中，采用放射免疫分析法检测了人类颈外静脉中神经肽的释放，并将其与通过多普勒超声监测大脑中动脉（MCA）和颈内动脉（ICA）的血流动力学变化（血管收缩）相关联。4. 与对照组相比，血流动力学发生变化的患者中神经肽Y样免疫反应性（NPY-LI）水平升高，并且在一些患者中发现速度与NPY-LI之间存在关联。5. 降钙素基因相关肽-LI水平也随着血管痉挛而升高。在患有MCA病变的患者中，血流动力学指数（V MCA/V ICA）与CGRP-LI之间的相关性为0.61，p = 0.0002。文中讨论了可能的交感神经和三叉神经-脑血管激活情况。
