脑外伤急性期血微量元素测定及临床研究

Determination of trace elements in patients with head injury at acute stage

目的探讨脑外伤患者全血微量元素在急性期的变化及其意义。方法分层随机抽样法，423例急性脑外伤患者按入院时GCS分为特重型脑伤组（GCS3～5分）、重型脑伤组（GCS6～8分）、中型脑伤组（GCS9～12分）及轻型脑伤组（GCS13～15分），采用BH5100S型原子吸收光谱仪检测伤后第3、7天全血铜、锌、镁、铁、钙的含量。正常对照组为健康体检者60例。结果伤后3、7天，各组之间铜、锌含量差异均无统计学意义（P〉0．05）；镁、铁的含量在特重型脑伤组中明显降低，差异有统计学意义（P〈0．05）；其余各组之间差异无统计学意义（P〉0．05）；特重型脑伤组和重型脑伤组的血钙水平明显高于中型脑伤组、轻型脑伤组和对照组。在急性期各脑伤组的血5种微量元素平均值均在正常参考值范围内。结论血镁、铁、钙元素含量在特重型脑伤中有明显变化，但脑外伤早期的铜、锌、镁、铁、钙平均值均在正常值内，因此用血微量元素含量来判断脑外伤急性期的严重程度意义不大。

Objective To investigate the changes and significance of trace elements in whole blood following head injury at acute stage. Methods 423 patients with acute head injury were selected using stratified random sampling method, and divided into the most severe group （GCS3-5）, severe group （GCS6-8）, moderate group （GCS9-12） and mild group （GCS13-15） according to Glasgow Coma Scale （GCS） at admission. 60 health adults were selected as control group. The blood sample would be collected on the 3rd and 7th day after injury. Copper, zinc, magnesium, iron and calcium in whole blood were tested by BH5100S atomic absorption spectrometer. Results On the 3rd and 7th day after injury, the levels of copper and zinc had no statistical differences among all groups （P〉0.05）. Compared with the control group, the concentrations of magnesium and iron were significantly low （P〉0.05）t in the most severe group, while that of calcium was significantly high （P〉0.05） in the most severe group and severe group. The levels of blood calcium in moderate and mild head injury group had no statistical difference from that in the control group（P〉0.05）. The average values of five trace elements were all normal in patients and controls. Conclusion The levels of calcium, magnesium and iron chang in patients with the most severe head injury. Aceordingly, it may be of little value to determine the severity of brain injury by means of the levels of trace elements.