Effects Of Fastigial Nucleus Stimulation For Plasma Endothelin-1 And Nitric Oxid Of Patients With Acute Cerebral Infarction

[Background and Object!Nitric oxid (NO) and endothelin-1 (ET-1) are endothelium-derived vasoactive factors, which also consist in nerve cells, vascular smooth muscle cells and macrophages. NO and ET-1 may also act as intercellular messenger involved in regulating blood pressure and nervous systems. The balance between physiological NO and ET-1 may adjust the vascular strain and effect on organic blood flow. Researchers have found that a great deal of NO produced by glia and macrophages could produce a lot of free radicals and increase the intracellular free Ca²⁺ obviously, which might result in nerve injury. Regional cerebral blood flow would reduced with the contraction of collateral vessels following overexpressed ET-1, and result in nerve cell lesion with ischemia.In 1998 Khayata reported that electrical stimulation of the cerebellar fastigial nucleus (FN) could reduced infarct volume of the brain ischemic rats. In 1995 Reis from USA put forward that electrical stimulation of the cerebellar FN could excite the central neuroprotection. To understand mechanism of protection of ischemic neurons of patients with ACI following FN electric stimulation , the plasma level of ET-1 and NO was investigated.[Methods]1.Establishment of model: Two stimulation electrodes were positioned mastoid process of patients with ACI and two assistant electrodes were positioned the lesion side of the patients with hemiplegia. Treatment parameter: duration: 45min, Bid; period of treatment: 15d. 2.Groups division: Sixty-eight patients with ACI were divided into the FN electric stimulation group (the treatment group) and conventional medicational group (the control group).We design the hypertension group because the selected patients with ACI had high blood pressure. 3. Observed object: (1)NO,ET-1 measurement: Blood of the patients were taken to detect the plasma levels of ET-1 and NO on the first day, the 3th day and the 7th day after they were in hospital. (2) stroke impairment assessment: Stroke neurologic impairment grade of the patients with ACI should be observed before treatment and the 30th day post-infarction.[Results]1. Difference was significant in the stroke impairment assessment of the treatment group before therapy and 30th days after therapy (P<0. 05). And, the stroke impairment assessment of the control group was also different before therapy and 30th days after therapy (P<0. 05). However, 30th days after treatment, difference was significant between the treatment group and the control group(P<0.05).2.Plasma levels of ET-1 and NO began to rise obviously during 24 hours in the patients with ACI (P<0.05). After 7th days, plasma levels of ET-1 and NO of the control group decreased obviously (P<0.05), but they were still higher than those of hypertensive group (P<0. 05). 3. The plasma ET-1 and NO of the treatment group declined more fast than those of the control group (P<0.05). The ET-1 and NO of FN electric stimulation group and hypertensive group were not different after 7th days (P>0.05).[Conclusion]1. The plasma ET-1 and NO of the patients with ACI begin to rise obviouslyduring 24 hours , then they gradually decline. And after 7th days , theplasma level of ET-1 and NO of the patients with ACI are close to normallevel.2.FN electric stimulation can decease the plasma levels of ET-1 and NOin patients with ACI, which may play a role in protection of ischemicneurons of patients with ACI.3.Electrostimulation of cerebella FN may promote the recovery ofneurologic function for acute infarction patients.