Estrada V, Téllez M J, Moya J, Fernández-Durango R, Egido J, Fernández Cruz A F
Hospital Universitario San Carlos, Madrid, Spain.
Am J Hypertens. 1994 Dec;7(12):1085-9. doi: 10.1093/ajh/7.12.1085.
The plasma levels of endothelin-1 (ET-1) and atrial natriuretic peptide (ANP) have been measured in 37 patients with acute ischemic stroke, on admission and 3 and 7 days thereafter. The plasma ET-1 levels at the onset of symptoms were about two-fold those observed in age-matched normal volunteers (3.5 +/- 2.26 v 1.54 +/- 0.9 pg/mL, respectively; P < .001). These levels remained significantly elevated during the 7-day study period. The neurologic deficit was assessed daily by Mathew's modified scale (MS). A significant correlation was found between neurologic status on admission and ET-1 plasma values; patients with worse neurologic status (MS < 45 points) had higher ET-1 plasma values than those with better neurologic status (MS > 45 points) (5.4 +/- 2.34 v 3.05 +/- 2.04 pg/mL, respectively, P < .05). The plasma ET-1 values did not correlate either with the site of the infarction or with its primary cause (cardioembolic, lacunar, or atherothrombotic). No significant differences were seen in plasma ET-1 concentrations between patients who eventually died and those who survived the acute event. The plasma ANP were about 18-fold higher in ischemic stroke patients on admission than in controls at admission (110.9 +/- 29.5 v 5.84 +/- 3.96 pg/mL, respectively, P < .01). These values remained significantly elevated on days 3 and 7. There was no correlation between the ANP plasma values and the neurologic status, the site or mechanism of the stroke, or the plasma ET-1 levels. In conclusion, ischemic stroke is associated with marked acute and long-duration increases of ET-1 and ANP.(ABSTRACT TRUNCATED AT 250 WORDS)
对37例急性缺血性脑卒中患者在入院时、入院后3天和7天测量了血浆内皮素-1(ET-1)和心钠素(ANP)水平。症状发作时血浆ET-1水平约为年龄匹配的正常志愿者的两倍(分别为3.5±2.26对1.54±0.9 pg/mL;P<.001)。在为期7天的研究期间,这些水平仍显著升高。每天用马修改良量表(MS)评估神经功能缺损。入院时的神经功能状态与ET-1血浆值之间存在显著相关性;神经功能状态较差(MS<45分)的患者血浆ET-1值高于神经功能状态较好(MS>45分)的患者(分别为5.4±2.34对3.05±2.04 pg/mL,P<.05)。血浆ET-1值与梗死部位或其主要病因(心源性栓塞、腔隙性或动脉粥样硬化血栓形成)均无相关性。最终死亡的患者与急性事件存活患者的血浆ET-1浓度无显著差异。缺血性脑卒中患者入院时血浆ANP比对照组入院时高约18倍(分别为110.9±29.5对5.84±3.96 pg/mL,P<.01)。这些值在第3天和第7天仍显著升高。ANP血浆值与神经功能状态、中风部位或机制以及血浆ET-1水平之间均无相关性。总之,缺血性脑卒中与ET-1和ANP的显著急性和长期升高有关。(摘要截短于250字)