血浆内皮素的变化与颅脑损伤程度及预后关系

Correlation of plasma endothelin with the severity and prognosis craniocerebral injury.

目的 研究颅脑损伤后病人早期血浆内皮素 (ET)的动态变化及与脑损伤程度及预后的关系。方法 5 0例颅脑损伤病人根据GCS评分为轻 (n =19)、中 (n =15 )、重 (n =16 )三组 ,在入院当日及第 3、 5、 7天用放射免疫法测定血浆ET水平。根据出院时GOS评分分为不良和良好两组。结果 入院当日病人血浆ET轻型和中型组轻度升高与正常对照组比较差别有意义 (P <0 0 5 ) ,重型组明显升高有显著意义 (P <0 0 1) ;第 3、 5、 7天轻型组逐渐降至正常水平(P >0 0 5 ) ,中型组逐渐升高 (P <0 0 0 1) ,第 7天略有回落 (P<0 0 1) ,重型组持续升高 (P <0 0 0 1)。血浆ET水平与GCS计分成明显负相关 (r=- 0 5 70 8,P <0 0 0 1)。预后不良和良好两组比较入院当日血浆ET差别有意义 (P <0 0 5 ) ,第 3、 5天 (P <0 0 1) 和第 7天差别更明显 (P <0 0 0 1)。结论 颅脑损伤病人血浆ET的变化与脑损伤程度相关 ,可作为判断伤情和预后的指标。

Objective To study the correlation of plasma endothelin (ET) with the severity and prognosis in craniocerebral injuried patients.Methods Fifty cases of craniocerebral injuried patients were divided into the following groups on the basis of the Glasgow Coma Scale(GCS):(1)mild group(n=19):GCS 13 to 15;(2)moderate group(n=14):GCS 9 to 12;(3)severe group(n=16):GCS 3 to 8.Plasma ET concentrations were measured with radioimmunoassay on the 1st、3rd、5th and 7th days of admission.The patients were divided into the unfavorable outcome and favorable outcome groups on discharge,according to the Glasgow Outcome Scale (GOS).Results Significant correlation were present between GCS and plasma ET level(r=-0 5708,P<0 001).Compared with the normal control group,plasma ET in mild and moderate groups on the first day of admission were markedly increased(P<0 05),severe group was very markedly increased(P<0 01);mild group was gradually decreased until the normal level(P>0 05) on the 3rd、5th and 7th days,moderate group was gradually increased (P<0 001) on the 3rd and 5th,little deceased on the 7th(P<0 01);severe group was continuously increased(P<0 001).The differences of plasma ET between the favorable outcome and unfavorable outcome groups were significant on the 1st day of admission(P<0 05),that were more obvious on the 3rd、5th(P<0 01) and on the 7th(P<0 001).Conclusion The changes of Plasma ET concentrations are correlated with the degree of brain lesion,which may judge the severity and prognosis of the patients with craniocerebral injury.