Kikumoto K, Kubo A, Hayashi Y, Minamino N, Inoue S, Dohi K, Kitamura K, Kangawa K, Matsuo H, Furuya H
Department of Anesthesiology, Osaka Neurological Institute, Toyonaka, Japan.
Anesth Analg. 1998 Oct;87(4):859-63. doi: 10.1097/00000539-199810000-00021.
Adrenomedullin (AM) is a potent hypotensive peptide originally identified in pheochromocytoma tissues. Impaired cardiovascular conditions, such as hypertension, myocardial infarction, and septic shock, stimulate production of AM. This study was performed to determine whether subarachnoid hemorrhage (SAH) altered plasma AM concentration. Plasma concentrations of AM in 17 patients with SAH were measured for 2 wk after the onset of SAH by AM-specific radioimmunoassay. Plasma concentrations of AM were increased in patients with SAH throughout the study period, compared with those in control subjects. Plasma concentrations of AM in patients classified as Hunt and Kosnik grade III or IV were significantly higher than those classified as Hunt and Kosnik grade I or II on the day of and the day after the onset of SAH. However, plasma concentrations of AM were unaffected by angiographic vasospasm. These findings suggest that plasma concentrations of AM are increased in patients with SAH and may reflect the severity of SAH.
Adrenomedullin has been reported to affect the cerebral circulation. This study was performed to determine whether subarachnoid hemorrhage, a typical cerebrovascular disorder, altered plasma adrenomedullin concentrations. We found that plasma adrenomedullin concentrations increased in patients with subarachnoid hemorrhage, although no relationship was found between plasma adrenomedullin concentration and angiographic vasospasm. Plasma adrenomedullin concentration may reflect the severity of hemorrhage.
肾上腺髓质素（AM）是一种最初在嗜铬细胞瘤组织中发现的强效降压肽。心血管疾病受损，如高血压、心肌梗死和感染性休克，会刺激AM的产生。本研究旨在确定蛛网膜下腔出血（SAH）是否会改变血浆AM浓度。通过AM特异性放射免疫分析法，在SAH发病后2周内测量了17例SAH患者的血浆AM浓度。在整个研究期间，SAH患者的血浆AM浓度均高于对照组。在SAH发病当天和发病后一天，Hunt和Kosnik分级为III级或IV级的患者血浆AM浓度显著高于分级为I级或II级的患者。然而，血浆AM浓度不受血管造影血管痉挛的影响。这些发现表明，SAH患者的血浆AM浓度升高，可能反映了SAH的严重程度。
据报道，肾上腺髓质素会影响脑循环。本研究旨在确定典型的脑血管疾病蛛网膜下腔出血是否会改变血浆肾上腺髓质素浓度。我们发现蛛网膜下腔出血患者的血浆肾上腺髓质素浓度升高，尽管血浆肾上腺髓质素浓度与血管造影血管痉挛之间未发现关联。血浆肾上腺髓质素浓度可能反映出血的严重程度。
