Platelet derived growth factor (PDGF) was identified as a powerful mitogenic growth factor which is released from activated platelets and has a marked activity as vasoconstrictor agent. In the present study we have measured cisternal cerebrospinal fluid (CSF) levels of PDGF in 72 patients operated on for intracranial aneurysm in order to verify whether it might be related to the clinical aspects of SAH with special regard to symptomatic vasospasm. CSF samples were obtained at surgery by cisternal puncture of the subarachnoid cistern the nearest to the aneurysm before aneurysm isolation and exclusion. The specimen were frozen in liquid nitrogen and stored at -80 degrees C until analysis. PDGF was measured using a commercially available reagent. Values are expressed as pg/ml of CSF. In 18 cases no radiological and clinical signs of SAH were detected and the mean cisternal CSF level of PDGF was 885.0 +/- 104.5 pg/ml; 20 patients were operated on between day 1 and 3 from the last SAH episode: mean cisternal CSF level of PDGF was 1917.5 +/- 459.4 pg/ml. In 34 patients treated with delayed surgery protocol, mean cisternal CSF level of PDGF was 995.3 +/- 73.8 pg/ml. Statistical analysis showed significant differences between groups (P: 0.011). In the subgroup of patients operated on within day 3 after SAH, 6 presented vasospasm and had mean cisternal CSF PDGF level which was significantly higher (P < 0.01) than in 14 patients without vasospasm. In the delayed "surgical" patients there was no significant difference in cisternal CSF levels of PDGF considering the occurrence of vasospasm. The results of the present study suggest that (a) after SAH there is a significant release of PDGF early after SAH and (b) higher levels of PDGF found in cisternal CSF of patients operated on within 72 hours after SAH may be predictive of symptomatic vasospasm.

译文

血小板衍生生长因子 (PDGF) 被鉴定为一种强大的有丝分裂生长因子,可从活化的血小板中释放出来,并具有明显的血管收缩剂活性。在本研究中,我们测量了72例因颅内动脉瘤手术的患者的脑池脑脊液 (CSF) 水平,以验证其是否可能与SAH的临床方面有关,特别是与症状性血管痉挛有关。在手术中,在动脉瘤隔离和排除之前,通过最靠近动脉瘤的蛛网膜下池穿刺获得CSF样本。将样品冷冻在液氮中,并在-80 ℃ 下保存直到分析。使用市售试剂测量PDGF。值表示为pg/ml的CSF。18例未检测到SAH的放射学和临床体征,PDGF的平均池CSF水平为885.0/- 104.5 pg/ml; 20例患者在最后一次SAH发作的第1天至第3天进行了手术: PDGF的平均池脑脊液水平为1917.5 +/- 459.4 pg/ml。在接受延迟手术方案治疗的34例患者中,平均池脑脊液中PDGF水平为995.3 +/- 73.8 pg/ml。统计学分析显示组间差异有统计学意义 (P: 0.011)。在SAH后第3天内进行手术的患者亚组中,有6例出现血管痉挛,平均脑池CSF PDGF水平显着高于14例无血管痉挛的患者 (P <0.01)。在延迟的 “手术” 患者中,考虑到血管痉挛的发生,脑池CSF的PDGF水平没有显着差异。本研究的结果表明 (a) SAH后,SAH后早期PDGF显着释放,(b) SAH后72小时内手术的患者的池脑脊液中发现较高水平的PDGF可能是症状性血管痉挛的预测因素。

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