Hamann G, Isenberg E, Strittmatter M, Schimrigk K
Department of Neurology, University of the Saarland, Homburg/Saar, FRG.
Stroke. 1993 Mar;24(3):383-6. doi: 10.1161/01.str.24.3.383.
Endothelin peptides are potent vasoconstrictors and thus are seen as potential cause of cerebral vasospasm after subarachnoid hemorrhage (SAH). Earlier reports showed elevated or normal endothelin levels in plasma and cerebrospinal fluid in patients suffering from SAH. The present study was designed to determine whether endothelin is a causal factor in SAH.
We studied 11 patients with acute SAH. Seven of these 11 patients had a proven aneurysm and six had experienced vasospasm. Big endothelin levels were determined by a radioimmunoassay recognizing the C-terminal peptide (normal range, 1-11 fmol/ml).
There were no elevations of big endothelin in the 59 plasma samples and the 17 simultaneously estimated cerebrospinal fluid samples. Differences between plasma and cerebrospinal fluid did not reach significant levels. Big endothelin values between patients with and without vasospasm showed no significant differences.
Our findings suggest that plasma elevation of the endothelins is not reproducible in SAH and that big endothelin is unlikely to be a causal plasma factor in the complex multifactorial development of vasospasm after SAH.
内皮素肽是强效血管收缩剂，因此被视为蛛网膜下腔出血（SAH）后脑血管痉挛的潜在病因。早期报告显示，SAH患者血浆和脑脊液中的内皮素水平升高或正常。本研究旨在确定内皮素是否为SAH的致病因素。
我们研究了11例急性SAH患者。这11例患者中有7例证实有动脉瘤，6例发生了血管痉挛。采用识别C端肽的放射免疫分析法测定大内皮素水平（正常范围为1 - 11 fmol/ml）。
59份血浆样本和17份同时测定的脑脊液样本中，大内皮素水平均未升高。血浆和脑脊液之间的差异未达到显著水平。有血管痉挛和无血管痉挛患者的大内皮素值无显著差异。
我们的研究结果表明，SAH患者血浆中内皮素水平升高不可重现，且大内皮素不太可能是SAH后血管痉挛复杂多因素发展过程中的致病血浆因素。
