脑外伤脑脊液中兴奋性氨基酸测定及其意义

Determination of excitatory amino acids in cerebrospinal fluid after cerebral injury and clinical significance

目的探讨脑外伤患者脑脊液中兴奋性氨基酸的变化。方法用邻苯二甲醛柱前衍生后，采用梯度高效液相色谱荧光检测法测定４２例脑外伤，９例对照者脑脊液中兴奋性氨基酸———天门冬氨酸（Ａｓｐ）和谷氨酸（Ｇｌｕ）。结果４２例脑外伤患者脑脊液中Ａｓｐ，Ｇｌｕ测值（Ａｓｐ：１．８７８±０７２９μｍｏｌ／Ｌ，Ｇｌｕ：７．９８５±６．３２５μｍｏｌ／Ｌ）明显高于正常对照组（Ａｓｐ：１．３６２±０．２２０，Ｐ＜００５），Ｇｌｕ：１．９１４±１．５０７，Ｐ＜０００１）。２６例重伤组脑脊液中Ａｓｐ，Ｇｌｕ测值（２．４０２±１．１５７μｍｏｌ／Ｌ，１０．２５２±６．５７０μｍｏｌ／Ｌ）明显高于轻伤组（１．７３２±０．５９５μｍｏｌ／Ｌ，Ｐ＜０００１，４．３０１±３．７４１μｍｏｌ／Ｌ，Ｐ＜００５）。脑外伤预后良好（良好；中残）组（Ａｓｐ：１．８３５±０．７０５μｍｏｌ／Ｌ，Ｇｌｕ：６．３０７±４．１７１μｍｏｌ／Ｌ，ｎ＝２４）与预后不良（重残；植物生存；死亡）组（Ａｓｐ：２．５８８±１．０８９μｍｏｌ／Ｌ，Ｇｌｕ：１２．５３０±７．２６９μｍｏｌ／Ｌ，ｎ＝１８）相比较，二组差异有非常显著意义（Ａｓｐ：Ｐ＜００１，Ｇｌｕ：Ｐ＜０?

Objective To study the change of excitatory amino——acids in cerebrospinal fluid after cerebral injury.Methods The concentration of exitatory amino aspartate and glutamate in cerebrospinal fluid was measured in 42 brain injured adults and 9 controls by precolumn derivatization with O phthaldehyde.Results The concentrations of excitatory amino acids in the cerebrospinal fluid of brain injured and severely injured group were higher than those of the controls (asp, P <0.05; Glu, P <0.001) and mild injured group (Asp, P <0.05; Glu, P <0.001). The excitatory amino acids values of poor outcome cases were conspicuously higher than those of good outcome cases (Asp, P <0.05; Glu, P <0.001).Conclusions The more severe the traumatic degree and the more poorer outcome, the higher concentration of exitatory amino acids in cerebrospinal fluid.