不同程度脑损伤骨折患者血清中神经肽Y含量及意义

Circulating levels and significance of neuropeptide Y in patients with different degree traumatic brain injury and fracture

目的通过对不同程度脑损伤并骨折患者血清中神经肽Y测量,探讨神经肽Y对脑损伤后骨折愈合加速的机制。方法选取临床健康体检者、单纯骨折、单纯脑损伤及脑损伤并骨折患者分别10、20、60、60例,脑损伤按GCS评分分轻中重3亚组,采用放射免疫法测量各组伤后24h、3、5和7d不同时间点患者血清中神经肽Y的含量。结果损伤后各组血清中神经肽Y含量明显升高,而后逐渐降低,其中单纯脑损伤与脑损伤骨折组各亚组在相同时间点差异不明显(P>0.05);伤后24h、3、5d脑损伤组、脑损伤骨折组中中、重度脑损伤与单纯骨折组比较神经肽Y含量明显升高,差异有显著性(P<0.05),与轻度脑损伤差异不明显(P>0.05),7d时重度脑损伤组神经肽Y含量明显高于轻度脑损伤组,差异有显著性(P<0.05)。结论临床脑损伤骨折患者骨痂量大、骨折愈合加速,而脑损伤骨折后患者血清中神经肽Y含量明显升高,尤以中重度脑损伤明显,结合以往研究可以推测神经肽Y可能是脑损伤后骨折愈合加速的因素之一。

[Objective] To observe the levels of neuropepetide Y in plasma of the patients with different degree traumatic brain injury combined fracture, to explore the mechanisms of neuropeptide Y accelerate the rate of fracture healing. [Methods] Sixty patients who underwent traumatic brain injury combined fracture were subjected to the brain injury and fracture group： Sixty patients who underwent traumatic brain injury were subjected to the brain in- jury only group, the patients with brain injury were subjected to three subgroups as mild, moderate, severe group by the Glasgow coma scale （GSC）： twenty patients who underwent fracture were subjected to the fracture only group： ten people in the control group have none illness from the health examination department of the hospital in the morning. We continuously measured the neuropeptide Y value at 24th hour, 3rd day, 5th day, 7th day in the plasma of all the men after injury and the control group people at a time in the morning by Radioimmune assay. [Results] After injury all the groups, the concentrations of neuropeptide Y were increased, the peak is about at the 3rd day, then decreasing .the mean levels of plasma neuropeptide Y between the subgroups of the brain injury only group and the bain injury combined fracture group has no significant differences at all time points （P 〈0.05）; the levels of plasma neuropeptide Y of the brain only group and the brain injury combined fracture group were much higher than the fracture only group at 24th hour, 3rd day, 5th day （P 〈0.05）; there was no significant differences between the subgroup of the mild brain injury only group or the mild brain injury combined group and the fracture only group at all the time points （P 〉0.05）, the levels of plasma neuropeptide Y of the severe brain injury were much higher than the mild injury brain subgroup at 7th day. [Conclusions] The clinical findings showed that the traumatic brain injury combined fracture patients has much bigger callus and more faster rate of healing fracture than the fracture only patients; the levels of plasma neuropeptide Y of the traumatic brain injury combined fracture were much significantly higher than the fracture only group, especially with servere traumatic brain injury, review the pasted studies it could supposed that neuropoptide Y can accelerate the rate of fracture healing and the levels of neuropepetide Y may be very much correlated with the rate of fracture healing.