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目的探讨动脉瘤性蛛网膜下腔出血（ＳＡＨ）患者血液及脑脊液中内皮素（ＥＴ）和一氧化氮（ＮＯ）的含量与脑血管痉挛（ＣＶＳ）及临床病情的关系。方法采用放射免疫方法测定血液和脑脊液中ＥＴ含量；采用硝酸还原酶法测定血液和脑脊液中ＮＯ的代谢产物ＮＯ－ｘ（ＮＯ－２和ＮＯ－３）含量。结果ＳＡＨ后血液和脑脊液中ＥＴ含量增高（Ｐ＜００５），且重症组高于轻症组（Ｐ＜００５）；而ＳＡＨ后血液和脑脊液中ＮＯ含量则下降（Ｐ＜００５），重症组下降更加明显（Ｐ＜００５）。结论提示ＳＡＨ后脑血管痉挛和迟发性脑缺血可能系ＥＴ升高和ＮＯ下降使大脑动脉持续收缩所致，且临床症状的严重程度与ＥＴ增高和ＮＯ下降的程度密切相关。本实验结果支持ＳＡＨ后ＣＶＳ发生机制中ＥＴ与ＮＯ动态平衡破坏学说。
Objective To investigate the relationship between endothelin (ET) and nitric oxide (NO) and cerebrovascular spasm (CVS) and its clinical status in patients with aneurysmal subarachnoid hemorrhage (SAH). Methods The content of ET in blood and cerebrospinal fluid (CSF) was determined by radioimmunoassay. The content of NO-x (NO-2 and NO-3) in blood and cerebrospinal fluid was measured by nitrate reductase method. Results After SAH, ET content in blood and cerebrospinal fluid increased (P <005), and in severe group was higher than that in mild group (P <005); however, NO content in blood and CSF decreased after SAH (P <0 05), severe group decreased more significantly (P <0 05). The results suggest that cerebral vasospasm and delayed cerebral ischemia after SAH may be caused by increased ET and decreased NO, leading to continuous contraction of cerebral arteries. The severity of clinical symptoms is closely related to the degree of ET and the decline of NO. The results of this study support the theory of dynamic equilibrium destruction of ET and NO in the pathogenesis of CVS after SAH.