慢性压迫性颈脊髓病手术前、后脑脊液中脂质过氧化物水平的变化

The content of lipid peroxides in CSF before and after operation in patients with chronic compressive cervical myelopathy

观察慢性压迫性颈脊髓病患者颈椎管扩大术前、后的脑脊液中脂质过氧化物水平的变化。对术前的30例、术后两周的21例患者行腰穿，留取2ml脑脊液（CSF），用荧光法测定丙二醛（MDA）含量，以16例无神经系统病变者的CSF作为对照。病人组术前CSF中MDA水平为54．38±12．64pmol／ml，对照组为35．95±9．12pmol／ml，经统计学处理P＜0．001，差异有显著性。术后对其中21例患者CSF中MDA水平进行测定，结果为43．44±10．51pmol／ml，与术前比较，P＜0．05，有显著性差异。提示自由基可能参与了慢性压迫性颈脊髓病脊髓损害过程，术后MDA水平降低可能与术后自由基生成减少有关，为颈椎管扩大术的临床疗效提出了一种新的解释。

To measure the level of lipid peroxides in cerebro-spinal fluid, which was obtained from pa-tients suffering from chronic compressive cervical myelopathy before and after "expansive open-doorIaminoplasty" operation. In 3o cases,lumbar puncture at L3-L4 level was performed just before opera-tion,and in 21 cases after operation two weeks later. 2ml CSF was obtained every time to determine thelevel of MDA, which is the main product of lipid peroxidation. Sixteen without neurological diseasewere recruited as normal control. Before operation, the level of MDA in patient group was 54. 38±12.64 pmol/ml, and was 35. 5± 9. 12 pmol/ml in control. The former was significantly higher than the lat-er. The post-operative level of MDA in patient group was 43. 44±10. 51 pmol/ml, which was slightlyhigher than that in control, but was significantly lower than that in pre-operation cases. Our resultssuggested that free radicals were involved in the pathogenic procedure of cervical chronic compressivemyelopathy. The decrease of MDA postoperative1y may result from the decreased production of free rad-icals. This study also provided an explanation of the mechanism of the clinical effect of "expansive open-door laminoplasty".