三叉神经痛患者血液降钙素基因相关肽的观察胡世辉.docVIP

三叉神经痛患者血液降钙素基因相关肽的观察胡世辉 摘要　目的：观察三叉神经痛发作时是否有降钙素基因相关肽参与，加深对三叉神经痛发病机理的认识。方法：用放射免疫法检测7例三叉神经痛患者疼痛发作时患侧颈外静脉血、肘静脉血及术后患侧颈外静脉血中降钙素基因相关肽的含量。结果：发现疼痛发作时患侧颈外静脉血中降钙素基因相关肽含量显著高于肘静脉血及术后患侧颈外静脉血中降钙素基因相关肽的含量。结论：我们认为：三叉神经痛的痛支神经过度合成和释放降钙素基因相关肽可能促进了P物质的释放，导致阵发性剧烈疼痛，并在局部形成神经源性炎症。 Observation of calcitonin gene-related peptide in blood of 　　the patients with trigeminal neuralgia. 　　Abstract Objective: To observe whether calcitonin gene-related peptide participates in the attack of trigeminal neuralgia and get a deeper understanding about its pathogenetic : Seven patients were studied, during the attacks venous blood was sampled from both the external jugular vein and cubital fossa vein ipsilateral to the pain, after operations the venous blood from external jugular vein was sampled again. Plasma levels of calcitonin gene-related peptide were determined using sensitive : During the attacks of trigeminal neuralgia the levels of calcitonin gene-related peptide in external jugular vein blood were significantly higher than that in cubital fossa vein blood and postoperative external jugular vein bloo : Exccesive synthetise and release of calcitonin gene-related peptide in trigeminal nerve may promote release of substance P, cause the intense paroxysmal pain and form a local neurogenic i hTTp://ａ.cOm } nflammation. 　　Key words　trigeminal neuralgia　calcitonin gene-related peptide　radioimmunoassay 　　降钙素基因相关肽是一种由降钙素基因表达的生物活性多肽，广泛分布于神经、心血管、消化、呼吸、内分泌等系统，参与机体许多功能的调节。由于CGRP与速激肽共存于感觉神经元中，在有关疼痛的研究中也引起了高度重视。目前尚不清楚三叉神经痛发作时是否有CGRP参与，我们用放射免疫法首次检测了7例三叉神经痛患者疼痛发作时血浆CGRP的含量，并就其临床意义进行初步探讨。 　　材料和方法 　　一、临床资料 　　原发性三叉神经痛患者7例，均为上海长征医院口腔科住院病人；其中男2例，女 5例，年龄44～78岁，平均年龄岁；第二支痛1例，第三支痛3例，第一、二支痛1例，第二、三支痛2例，病程3 ～12年，平均年；入院前所有患者均未作过手术、射频及封闭治疗，有明确的扳机点；入院后均行三叉神经颅底高位切断术［1］。 　　二、方法 　　1. 采样：刺激患者扳机点，诱发患者疼痛发作，迅速抽取患侧颈外静脉血及肘静脉血各5ml，术后1周，确认无疼痛发生，再抽取患侧颈外静脉血5ml，所抽血液迅速注入预冷的含有肝素和抑肽酶的试管内离心，离心后提取血浆，置入－20℃冰箱内备测。