肺炎并中枢神经系统症状患儿脑脊液中谷氨酸、γ-氨基丁酸含量的变化及其意义

Changes of glutamate and GABA in cerebrospinal fluid of patients with pneumonia complicated with central nervous system damage

测定１８例肺炎并中枢神经系统（ＣＮＳ）受累患儿（肺炎Ⅱ组）、１４例肺炎无ＣＮＳ受累患儿（肺炎Ⅰ组）和７例低钙抽搐患儿脑脊液（ＣＳＦ）中谷氨酸（Ｇｌｕ）、γ氨基丁酸（ＧＡＢＡ）及丙二醛（ＭＤＡ）含量的变化。结果示肺炎Ⅱ组ＣＳＦ中Ｇｌｕ和ＧＡＢＡ含量及Ｇｌｕ／ＧＡＢＡ比值明显高于肺炎Ⅰ组和低钙抽搐患儿组，且肺炎伴有惊厥后出现意识障碍者ＣＳＦ中Ｇｌｕ／ＧＡＢＡ比值明显高于未出现意识障碍者。提示Ｇｌｕ及自由基参与肺炎患儿脑损伤的发生发展过程，而ＧＡＢＡ有助于减轻肺炎时脑损伤的程度。

Glutamate(Glu), γ aminobutyric acid(GABA), and malondialdehyde(MDA) in cerebrospinal fluid(CSF) were measured in 18 children with pneumonia complicated with central nervous system(CNS) damage, 14 children with pneumonia without CNS damage, and 7 children with hypocalcemic tetany. The concentration of Glu and MDA and the ratio of Glu/GABA in CSF of pneumonia without CNS damage were significantly higher than the others. The ratio of Glu/GABA in CSF of the children with pneumonia with consciousness obstacle after convulsion was higher than that without consciousness obstacle after convulsion. These results suggest that Glu and free radicals may play a critical role in the CNS damage caused by pneumonia, however GABA may reduce the CNS damage caused by pneumonia.