The Research About The Role The Cholinergic Anti-inflammatory System Of Multiple Organ Dysfunction Syndrome Caused By Acute Cerebrovascular Disease

Objective In ACVD patients with MODS to serum endotoxin, acetyl choline enzyme, tumor necrosis factor expression and neural function, the continuous monitoring of acute physiology and chronic health evaluation and lacunar cerebral infarction patients and healthy people, Clear the the possible regulatory mechanism. of vagus nerve- cholinergic anti-inflammatory pathway in the course of ACVD patients with MODS occurred.Methods 1. Clinical collect CMODS patients, patients with lacunar cerebral infarction, 24 hours,72 hours, 7 days, 14 days early in the morning on an empty stomach elbow venous blood 10 ml, And in the same period of healthy check-up elbow venous blood 10 ml in anticoagulant tubes, 2000 r/min centrifuge for 10 min, Draw the upper serum respectively,- 80 ℃ refrigerator cryopreservation. 2. Detective the Change of each time point of peripheral blood WBC, liver and kidney function. 3. Adopt improved chromogenic limulus test method to determine the bacterial endotoxin in the matrix. 4. The enzyme mark immunosorbent(ELISA) to detect the expression of TNF alpha. 5. The HPLC method to detect the content of acetylcholine. 6. 90 cases of the subjects are in the 24 h, 72 h, 7 d, 14 d and 28 d assessment at the national institutes of health stroke scale(NIHss) scores, Acute physiology and chronic health evaluation system Ⅱ(APACHE Ⅱ), Thequestionnaire of drug treatment. 7. Statistical methods Results were expressed as X±S. One-way-ANOVA of SPSS 17.0 soft ware was used to evaluate the difference among groups. Correlation analysis of SPSS 16.0 was used, too.Results 1. MODS group respectively in lacunar cerebral infarction control group and healthy controls were compared between groups, MODS group of endotoxin and tumor necrosis factor levels with lacunar cerebral infarction control group and healthy control group of endotoxin and tumor necrosis factor levels differ significantly(P<0.01); MODS group acetylcholine content with lacunar cerebral infarction control group and healthy controls acetylcholine content difference obvious(P<0.01). 2. MODS group three biological detection index content and NIHSS score and APACHE Ⅱ rating respectively in 24 hours, 72 hours, 7 days, 14 days, correlation analysis, Acetylcholine content and NIHSS score, APACHE Ⅱ score negatively correlated; Endotoxin content, tumor necrosis factor levels and NIHSS score and APACHE Ⅱ scores were positively correlated.Conclusion 1. The vagus nerve- acetylcholine pathway in patients with ACVD to MODS is activated. Endotoxin concentration and SIRS in patients with ACVD involved in MODS development process. 2. The vagus nerve- cholinergic anti-inflammatory pathway have self protection function for adjacent organs...