くも膜下出血患者における髄液中bradykinin （BK）の経時的測定

SERIAL MEASURMENT OF BRADYKININ OF CEREBROSPINAL FLUID IN PATIENTS WITH SUBARACHNOID HEMORRHAGE

　抄録　くも膜下出血患者21例の髄液中bradykinin （BK）をRIA法により経時的に測定した。この結果発症日134.9±93.9pg／ml （平均値±標準偏差），1日目38.3±31.8pg／ml,2日目23.4±22.8pg／ml,3日目16.6±9.9pg／ml,4日目15.5±6.0pg／ml,5日目14.8±5.9pg／mlを得た。BKの対照値は8.0±3.3pg／ml （n＝10）であった。一方，脳内出血による脳室内穿破の患者5例の血性髄液中BKは初期に高値をとることはなかった。くも膜下出血においてBKが大量に産出されるのは，くも膜下腔のcollagen bundlesであるtrabeculaによって血漿中Hageman factorが活性化されることによると考えられる。

The bradykinin (BK) concentration of the cere-brospinal fluid (CSF) in 21 patients with sub-arachnoid hemorrhage (SAH) was measured serially by radioimmunoassay (RIA). The values were 134.9±93.9pg/ml (mean±standard deviation) on the day of onset, 38.3±31.8pg/ml on the first day after onset, 23.4±22.8pg/ml on the second day, 16.6±9.9pg/ml on the third day, 15.5±6.0pg/ml on the fourth day, and 14.8±5.9pg/ml on the fifth day. In the controls the BK concentration in the CSF was 8.0±3.3pg/ml (n=10). On the other hand, none of 5 patients with intraventricular hematoma due to intracerebral hemorrhage had a high level of BK in the bloody CSF at the initial stage (15.2-26.0pg/ml).

This shows that BK is not produced only by the mixture of CSF and blood. BK is produced by the activation of Hageman factor that is considered to be activated by trabecula of collagen bundles in the subarachnoid space in the case of SAH.