急性一氧化碳中毒迟发脑病脑脊液中兴奋性氨基酸水平的变化

Changes of excitatory amino acids of cerebrospinal fluid in patients with delayed encephalopathy after acute carbon monoxide poisoning

目的研究急性一氧化碳中毒迟发脑病（DEACMP）患者脑脊液中兴奋性氨基酸水平的变化及其临床意义。方法采用高效液相色谱（HPLC）法测定24例DEACMP患者（DEACMP组）及20例偏头痛缓解期患者（对照组）脑脊液中兴奋性氨基酸的主要组分谷氨酸（Glu）、天门冬氨酸（Asp）水平。结果DEACMP组患者脑脊液中Glu、Asp水平高于对照组[（3．76±1．52）μmol／L比（1．55±1．03）μmol／L；（0．73±0．44）μmol／L比（0．38±0．33）μmol／L，P均〈0．01]，且神经功能缺损程度越重，Glu和Asp水平越高。结论兴奋性氨基酸参与DEACMP病理过程，脑脊液中兴奋性氨基酸水平升高，可能提示早期DEACMP的发生。

Objective To investigate the changes of excitatory amino acids （EAAs） of cerebrospinal fluid （CSF） in patients with delayed encephalopathy after acute carbon monoxide poisoning （DEACMP）. Method The EAAs levels of CSF including glutamate （Glu） and aspartate （Asp） in 24 patients with DEACMP and 20 controls with migraine were measured by high performance liquid chromatography（ HPLC ）. Results Glu and Asp levels in patients with DEACMP were significantly higher than those of the controls [（3.76± 1.52）μ mol/L vs （1.55± 1.03） μmol/L,（0.73 ± 0.44）μmol/L vs （0.38±0.33） μmol/L, Pall 〈 0.01 ]. Glu and Asp levels in moderate and severe DEACMP patients were higher than those in mild DEACMP patients. Conclusion It suggests that EAAs participated in the pathogenesis of DEACMP. The Glu and Asp levels in CSF may be regarded as indicator of DEACMP.