脑外伤患者髓鞘碱性蛋白检测的应用

Application of Serum and Cerebrospinal Fluid Myelin Basic Protein(MBP)Detection on Traumatic Brain Injury

目的检测脑外伤患者不同时期血清及脑脊液髓鞘碱性蛋白(MBP),以观察其在疾病发生、发展过程中的变化,为临床的诊治提供依据。方法选取轻、中、重型脑外伤患者各20例作为试验组,另选取20例脑振荡患者作为对照组,分别于应急期、水肿期、功能康复期采集患者血清和脑脊液,采用ELISA方法检测MBP,并进行统计学分析。结果血清、脑脊液MBP浓度与疾病的严重程度相关,重型脑外伤患者在应急期和水肿期的血清、脑脊液MBP浓度高于中型脑外伤患者,更高于轻型脑外伤患者,且试验组轻、中、重型患者均高于对照组,差异有极显著意义,P<0.01;血清、脑脊液MBP浓度还与病程密切相关,应急期、水肿期的血清、脑脊液MBP浓度均明显高于康复期,差异有极显著意义,P<0.01;血清、脑脊液MBP水平也与损伤类型和颅内血肿大小相关,脑挫裂伤合并颅内血肿患者血清、脑脊液MBP水平高于局限性脑挫裂伤患者,更高于硬膜外血肿患者,差异有极显著意义,P<0.01,脑外伤患者颅内血肿越大,MBP水平越高。结论血清、脑脊液MBP是判断脑外伤损伤程度和预后的良好指标,可作为脑外伤诊断、治疗和预后判断的重要客观依据。

Objective To detect the concentration level of serum and cerebmspinal fluid Myelin Basic Protein（ MBP） of patients after traumatic brain injury so as to observe its changes in different course of affection for chnieal diagnostic. Methods Choose 20 cases of light, medium and severe traumatic brain injury patients each as a trial group and another 20 cases of cerebral concussion patients as a comparison group, and then collect their serum and cerebrospinal fluid samples during emergency period, edema period and rehabilitation period separately. The MBP concentration level of the samples was statistically analyzed through ELISA. Results The concentration level of serum and cerebrospinal fluid MBP is related with injury severity. The MBP level of severe patients was higher that of medium patients and much higher than that of light ones, and the MBP concentration of all patients in the trial group was higher than that from comparison group, which had great statistical significance（ P 〈 0.01 ）. The MBP concentration level also had close relation with the course of disease. It was distinctly higher in emergency and edema periods than that in rehabilitation period and there was obviously statistical significance as well （ P 〈 0.01 ）. The MBP concentration level changed with injury type and Encephalic Hematoma size. The MBP level of patients with cerebral contusion and laceration and Encephalic Hematoma was also higher than those with cerebral local contusion and laceration and much higher than those wiht Extradural He matoma, with great statistical sign/ficanee （ P 〈 0.01）. The bigger the Encephalic Hematoma, the highe~~ the MBP level. Conclusion The MBP concentration level of serum and cerebrospinal fluid is a good index for diagnosis of traumatic brain injury severity and for prognosis, and it can be used as an important objective reference for diagnosis, treatment and prognosis of traumatic brain injury.