急性颅脑损伤颅内出血、脑梗死患者血浆Hcy、NPY、β_2-m和Cor水平的临床意义

Clinical Study on the Changes of Plasma Hcy,β_2-m,Cortisol,NPY Levels and NPY Contents in CSF in Patients with Acute Traumatic Intracranial Hemorrhage as well as Patients with Cerebral Infarction

目的:为了探讨急性颅脑损伤颅内出血和脑梗死患者血浆(CSF)中Hcy、β2-m、皮质醇(Cor)和神经肽Y(NPY)的临床意义。方法:68例急性颅脑损伤颅内出血,39例脑梗死和35例正常对照组血浆β2-m、Cor(8h和24h)和NPY(CSF)的测定应用放射免疫分析,血浆Hcy的测定采用化学发光免疫分析。结果:急性颅脑损伤颅内出血和脑梗死患者血浆Hcy和β2-m水平明显高于正常对照组(P<0.01),全部病例组的8h和24h的Cor均高于正常对照组(P<0.01),并随着疾病的严重程度而增高,8例急性颅脑损伤颅内出血治疗后死亡的病例,血浆Cor持续增高,而脑脊液中NPY水平较之血浆更具诊断意义。结论:血浆和脑脊液中的Hcy、β2-m、NPY和Cor参与急性颅脑损伤颅内出血和脑梗死发生和发展过程,并具有重要的临床意义。

Objective To investigate the clinical significance of the changes of plasma Hcy, β2 - m, cortisol, NPY levels and NPY contennts in CSF in patients with acute traumatic intraeranial hemorrhage as well as patients with cerebral infarction. Methods Plasma β2 -m, cortisol, NPY, NPY in CSF （with RIA） and plasma Hey （with CLIA） contents were measured in 68 patients with acute traumatic intraeranial haemorrhage （ mild 33, severe 35 ） as well as 39 patients with cerebral infarction （ plus 35 controls）. Results The plasma β2 - m, Hey and 8h, 24h cortisol levels in all these patients were significantly higher than those in controls （P 〈 0. 01 ）. The cortisol levels were significantly higher in the severe traumatic cases than these in the mild traumatic cases （P 〈 0.05）, with persistents very high levels in 8 patients succumbed to toauma. However, plasma NPY levels among all the patients varied little from the levels in controls. Yet NPY contents in CSF were significantly higher in all the patients than those in controls （ P 〈 0.01 ）. Conclusion Increases in plasma β2 -m, Hcy, cortisol levels and NPY contents in CSF were very prominent in all these patients studied.