摘要
本文采用［Ｉ１２５］放射免疫方法，测定了５５例格拉斯哥昏迷积分（ＧｌａｓｓｇｏｗＣｏｍａＳｃａｌｅ－ＧＣＳ）３～１５分的急性颅脑外伤病人与２０例对照病人血清及脑脊液中环－磷酸腺苷酸（ｃＡＭＰ）、环－磷酸鸟苷酸（ｃＧＭＰ）的浓度。研究发现，ＧＣＳ介于３～８分病人的ＣＳＦ－ｃＡＭＰ、ＣＳＦ－ｃＧＭＰ含量均低于对照组，而ＧＣＳ介于９～１５分病人的ＣＳＦ－ｃＡＭＰ、ＣＳＦ－ｃＧＭＰ均有不同程度的升高，随ＧＣＳ的下降而升高。在颅脑外伤病人，血清ｃＡＭＰ、ｃＧＭＰ含量均高于对照组，但与外伤程度无明显相关性。动态观察表明，颅脑外伤后ＣＳＦｃＡＭＰ含量升高，预示病情预后良好。外伤后昏迷病人ＣＳＦ－ｃＡＭＰ含量的持续下降以及一度升高后的严重下降，均提示预后欠佳。研究结果表明，ＣＳＦｃＡＭＰ作为一种代谢性生化指标，更能弥补现代影像学设备（如ＣＴ、ＭＲＩ等）在颅脑外伤诊断方面的不足、对颅脑外伤病人的病情诊断及预后评估有着重要的临床意义。
We performed a sensitive and specific radioimmunoassays for cyclic adenosine 3'-5'-monophosphate(cAMP).Cyclic guanosine 3'5'-monophosphate(cGMP) inserum and cerebrospinal fluid(CSF) in 55 patients with acute brain trauma with Glasgow Coma Scal(GCS) of 3 to 15 and 20 agematched control patients.In CSF of patients with GCS of 3-8,the concentrations of cAMP and cGMP were both lower than those in CSF of control group.In CSF of patients with GCS of 9-15,the concentration of cAMP was higher than that in CSF of control group and increased in proportion to the severity of brain trauma.There is no correlation of cAMP and cGMP between CSF and serum.The concentration of cAMP and cGMP in serum was increased,put there was no correlation with the severity of brain trauma.AS a biochemical marker for central nervous system trauma,CSF-cAMP is significant in the assessment of the severity with brain trauma and prognosis,and may be complementary to moden imaging techology
