血清Mg^(2+)在急性颅脑外伤中的诊治价值

Clinical Significance of the Changes of Serum Magnesium in Acute Craniocerebral Injury

目的:观察急性颅脑外伤(ACI)血清Mg2+浓度变化对脑细胞功能的影响。方法:测定ACI时,GCS>8分与GCS≤8分两组病例血清Mg2+浓度、Ca2+浓度、脑血管痉挛发生率、脑血氧饱和度,低镁血症患者1个月后预后评分(GOS)及外源性硫酸镁的临床疗效。结果:ACI患者血清Mg2+浓度明显低于正常对照组,且降低程度与脑伤程度正相关;GCS≤8分者低镁血症发生率明显高于GOS>8分者;低镁血症患者其脑血管痉挛发生率明显高于对照组,脑血氧饱和度明显低于对照组,GOS评分≤3分者明显多于对照组;24h内给予硫酸镁治疗能明显提高GOS评分。结论:Mg2+作为脑组织的重要能量代谢和调节因子,其浓度的降低直接参与了ACI时继发性脑损害,与伤情及预后密切相关。早期给予硫酸镁对脑组织有明确的保护作用。

Aim： To investigate the protective effects on cerebral cell of the serum magnesium level changes in patients suffering acute craniocerebral injury （ACI）. Methods： The levels of sennn IMg^2＋ , serum ICa^2＋, cerebral vasospasm （CVS）, regional cerebral oxygen saturation （rSeO2） were measured in 85 cases of ACI. The Glasgow outcome scale of patients with hypomagnesemia were observed. Results：With MgSO4 at 12 hours postinjury demonstrated significantly. The IMg^2＋ levels of patients with ACI decreased siginificantly compared with control group, and there is a positive correlation between the GCS and the IMg^2＋ levels, It is easier to suffer CVS, cerebral hypoxemia, worse outcome in patients with hypomagnesemia than in control group. The patients with hypomagnesemia treated improved motor outcomes compared with treated control patients at 24 hours. Conclusion： The present results demonstrated that magnesium played a neuroprotective role following ACI. The dynamical meaurements of IMg^2＋ levels are conductive to evaluate the severity and prognosis of the patients with ACI. Moreover, the early treatments （up to 24 hours） provide the most significant benefit.