Study Of The Relationship Between The Activity Changes Of Angiotensin Ⅱ, Arginine-vasopressin And Cognitive Impairment After Stroke And Therapy Effect Of Tetramethylphrazim

Obj ective①To study the relationship between the activity changes of Angiotensin II(AngII),Arginine vasopressin(AVP)in plasma,cerebrospinal fluid(CSF)and cognitive impairment after stroke．②To estimate the correlations among the cranial imaging characteristics,the suffering situation of brain nerve cell and the cognitive function after stroke．③To explore the therapy effect of TMP on cognitive impairment after stroke and its mechinism． Methods①To measure the concentrations of AngII,AVP and Tumour necrosis factor—a(TNF-a)in plasma and CSF by radioimmunoassay(RIA)technology；tO assay the level of Neuron—specific enolase(NSE)by enzyme—linked allergosorbent test(ELISA)in 5 0 patients with Vascular dementia(VD)group,62 patients with Cerebral infarction(CI)group and 26 cases wim functional disease in Central nervous system(control group)．②To test cognitive function by Mini-Mental State Examination(MMSE),Hachinski Ischemic Scale(HiS)and P300 peak latencies(P300PL)．③The patients with VD were treated randomly by TMP or Ginaton,their therapy effects on cognitive impairment were compared,and their pharmacological functions were studied． Results ①In VD group the infarction focus was more fi~equently located in the bilateral cerebral hemisphere,thalamus,temporal lobe and frontal lobe than that in CI group．The multiple infarctions in VD group were more frequently be seen than that in CI group．②As compared with CI group of recovery phase or in control group,in VD group the concentrations of AVP in plasma were no significantly difference(P>0。05)； AngII level in CSF was markedly increased(P<0．o i),AVP level in CSF was markedly decreasly(P<0．0 1),the scoreof MMSE was significantly lowered(P0．05)；between CSF TNF．a／plasma TNF．a level or CSF NSE／plasma NSE level Was positive correlation significantly(P<0．o 1)．In VD group P3 OOPL／CSF AVP level was negativecorrelation significantly(P<0．01)；P300PL／CSF AnglI level was positive correlation significantly(P0．05)．⑤In VD group,after treated with TMP or Ginaton．1evel of AnglI in plasma or CSF Was markedly lower(P<0．0 1)；level of AVP in CSF or scores of MMSE was significantly increased(PO．05)． Conclusions ①The cranial imaging characteristics may be the importantindex to predict cognitive impairment after stroke．②It play an important role of activity changes of AVP,AnglI in pathOphysiOlOgical process of cognitive impairment after stroke．~The changes of TNF．a,NSE levels in CSF couId dynamically respond the brain injury in patients with VD．However,It could not directly indicate the intellectual status of VD patients．@TMP can improve cognitive function after stroke,．It may be related with improving of the disorders of AngII,AVP in central nervous system．...