颅脑外伤后血清、脑脊液髓鞘碱性蛋白的变化及其临床意义

Change and its clinical significance of myelin basic protein in serum and cerebrospinal fluid in patients with brain injury

目的①探讨颅脑外伤后血清、脑脊液髓鞘碱性蛋白(MBP)的变化及其意义;②探讨血清、脑脊液MBP水平与伤情、CT、颅内压(ICP)、脑灌注压(CCP)的关系。方法采用免疫组化法测定90例颅脑损伤病人伤后24h内、3d、7d时的血清、脑脊液MBP水平,并结合颅脑损伤程度、CT、ICP、CPP进行分析。结果①颅脑损伤病人血清、脑脊液MBP浓度升高的程度与脑损伤程度密切相关;②血浆、脑脊液MBP水平随ICP增加而升高,随CPP增高而降低;③血清、脑脊液MBP水平随CT图像改变而变化。结论监测血清、脑脊液MBP浓度,联合CT、ICP、CPP等指标,可更准确地判断病情。

Objective To investigate the changes and its clinical significance of myelin basic protein （MBP） of serum and cerebrospinal fluid in patients with brain injury and determine the correlation between the MBP levels and the GCS score, CT scan findings, intracranial pressure （ICP） and cerebral perfusion pressure （CPP）. Methods Serum and cerebrospinal fluid MBP levels in 90 adult patients with acute brain injury were detected by enzyme-linked immunoabsorbent assay within 24 hours, on the third day and the seventh day after injury. The relationship between the MBP levels and GCS score, CT scan findings, ICP, CPP were analyzed. Results Serum and eerebrospinal fluid MBP concentrations were positively related to the injury severity. The MBP concentration increased when the ICP increased, while decreased when the CCP increased. The MBP concentration varied when the CT scan findings had changes. Conclusion Monitoring the concentrations of serum and cerebrospinal fluid MBP, ICP and CPP, and CT scanning are helpful in evaluating the neurological state of head injured patients.