严重脑外伤患者外周血淋巴细胞糖皮质激素受体的研究

THE STUDY OF LYMPHOCYTES GLUCOCORTICOID RECEPTOR IN SEVERE HEAD INJURY

用放射配体结合分析与ＲＩＡ分别研究了１１例正常人及１４例严重脑外伤患者的外周血淋巴细胞糖皮质激素受体水平及血浆皮质醇水平，结果表明：正常对照组糖皮质激素受体（ＧＣＲ）为６５６１±１６６０位点／细胞，皮质醇（８ａ．ｍ．）为２０８．９±５４．７ｎｇ／ｍｌ；高受体组患者ＧＣＲ为５２５９±１６８６位点／细胞，皮质醇（８ａ．ｍ．）为８８０．４±４６９．８ｎｇ／ｍｌ；低受体组患者ＧＣＲ为３００４．４±１００５．６位点／细胞，皮质醇为１５６５．１±６３１．８ｎｇ／ｍｌ。高受体组患者４例均痊愈，低受体组患者１０例中死亡８例，两组死亡率有明显差异（Ｐ＜０．０１）。故可以认为ＧＣＲ与脑外伤患者临床应激状态对糖皮质激素治疗疗效以及预后密切相关。外周血淋巴细胞代替脑组织活检用于ＧＣＲ检测具有取材方便、可反复观察、易于为患者所接受等优点，可反映脑组织ＧＣＲ的变化趋势。

Glucocorticoid receptors(GCR)of peripheral lymphocytes from 14 patients with severe head in-jury and 11 normal volunteers are studied by means of single point method of radioligand binding as-say. All these patients receive surgical therapy and glucocorticoid of routine dosage.The results showthat the GCR level of these patients is lower than that of the normal,while the plasma cortisol level ismuch higher.These changes correlate closely to the patients' clinical outcome.It is indicated that theGCR level can reflect the degree of stress of these patients and their response to glucocorticoid therpy.Using peripheral lymphocytes instead of the brain biopsy for the rneasurement of GCR can reflect theGCR changes of brain tissue,it's more convenient to get the sample and more acceptable to the pa-tients.