急性颅脑损伤后脑脊液抑制性氨基酸的变化及意义.docVIP

急性颅脑损伤后脑脊液抑制性氨基酸的变化及意义 桃江县人民医院 目的探讨脑脊液中抑制性氨基酸的水平与颅脑损伤严重程度的关系。方 法 将71例急性颅脑损伤患者按入院时GCS评分分为9?15分组(37例)和3?8 分组(34例)，伤后1、3、7d采集脑脊液标木；以28例正常脑脊液标木作对照 组。采用柱前衍牛反相高效液相色谱紫外吸收检测法定量分析脑脊液标木中 gamma;-氨基丁酸(GABA)、牛磺酸(Tau)和丙氨酸(Ala)浓度。结果颅脑 损伤后脑脊液GABA、Tau浓度均高于对照组，GCS 3?8分组Tau浓度均明显高 于GCS9?15分组(Plt;0.05)o颅脑损伤后1、7d, GCS 3?8分组GABA浓度高 于GCS 9?15分组(Plt;0.05),伤后3 d时两组浓度无显著性差异(Pgt;0.05)o 颅脑损伤后Ala浓度较对照组明显下降(Plt;0.05)o结论 脑脊液GABA、Tau在 颅脑损伤后反应性增高提示其可能与颅脑损伤的严重程度相关。脑脊液Ala浓度 在颅脑损伤后下降提示颅脑损伤后部分脑保护机制受到损害。 关键词颅脑损伤；抑制性氨基酸；gamma;-氨基丁酸；牛磺酸；丙氨酸；脑 脊液 [Abstract] Objective To study the relati on ship betwee n cha nge in in hibitory amino-acid in cerebrospinal fluid (CSF) and the severity of acute traumatic brain injury (TBI) .Methods Seventy?one patients with acute TBI were divided into group A (GCS 3 ?8, n 二 34) a nd group B (GCS 9 ?15, n 二 37) accordi ng GCS o n admitta nee to hospital.The contents of taurine (Tau), gamma;- aminobutyric acid (GABA) and alanine (Ala) in all the patients CSF, which was collected 1, 3 and 7 days after TBI, and 28 normal CSF samples collected from healthful subjects serving control were determined by reserved phase high performanee liquid chromatography ultraviolet detection with precolumn derivatization.Results CSF contents of Tau and GABA were sign讦icantly higher in groups A and B 1, 3 and 7 days after TBI than those in the control group (Plt;0.01) .CSF contents of Tau were sigrdficantly higher in group A than those in group Bl, 3 and 7 days after TBI(Plt;O.Ol).CSF contents of GABA were significantly higher in group A than those in group B 1, 3 and 7 days after TBI (Plt; 0.01) CSF content of GABA were significantly in group higher in group A than those in group B 1, 3 and 7 days after TBI (Plt; 0.01) CSF content of Ala in group 7 days after TBI and CSF contents of Ala in group B 1, 3 and 7 days after TBI were significantly lower than those in the contro group (Plt;0.05) .Conclusion Tau and GABA contents in CSF after TBI are positively related to the severity of TBI. [Key words]