重型脑外伤急性期血儿茶酚胺与肺脏病理变化及其意义

Changes of Serum Catecholamines and Pulmonary Pathology in Patients with Severe Head Injury

报告４８例重型脑外伤患者血儿茶酚胺（ＣＡ）测定结果及其中１３例肺活检光、电镜观察所见，３５例正常人血ＣＡ作对照组。结果表明：外伤组血ＣＡ明显高于对照组。死亡组病人伤后２４小时内和第３天血ＣＡ均高于存活组（Ｐ＜０．０１）。肺脏病理改变主要为肺泡萎陷，上皮细胞及血管内皮细胞肿胀变性，肺泡间隔及肺泡腔水肿，细胞浸润等。死亡组病变明显重于存活组，两组间尤以超微结构病理改变差别显著。结合文献讨论了重型脑外伤急性期血ＣＡ变化与肺脏病理改变的关系及其临床意义。

The serum levels of catecholamines (CA) including norepinephrine (NE) and epinephrine (E),were measured in 48 adult patients with severe head injury and in 35 normal adults as a control group.In 13 cases of the 48 patients,the biopsy of pulmonary tissue was made for the observation of photomicroscopy and electromicroscopy.The results showed that the serum CA level was significantly higher in the injury group than in the control.The serum NE and E levels were higher in the dead group than in the survival group within 3 days after injury.The main pulmonary pathologic changes of the patients included microatelectasis,alveolar epithelial cell and capillary endothelial cell swelling,degeneration,alveolar septums and cavity exudation,edema,white cell infiltration and so on.These pathological changes,especially the ultramicrostructural pathology,were more severe in the dead group than in the survival group.Clinical significance and the relationship between serum CA and pulmonary pathological changes are discussed.(Original aritcle on page 104)