摘要
以往的研究发现质子磁共振频谱分析对于预测儿童外伤性脑损伤(TBI)神经系统预后有价值。取自代谢物的N-乙酰基减少及乳酸盐出现意味着较差的预后。作者利用光谱分析检测了另一种代谢物肌醇,来测定TBI后是否有改变。
Previous studies have shown that proton magnetic resonance spectroscopy (MRS) is useful in predicting neurologic prognosis in children with traumatic brain injury (TBI) . Reductions in N-acetyl derived metabolites and presence of lactate have been predictive of poor outcomes. We examined another spectroscopy metabolite, myoinositol (ml), to determine whether it is altered after TBI. Found primarily in astrocytes, ml functions as an osmolyte and is involved in hormone response pathways and protein-kinase C activation. Myoinositol is elevated in the newborn brain and is increased in a variety of diseases. We studied 38 children (mean age 11 y; range 1. 6 - 17 y) with TBI using quantitative short echo time occipital gray and parietal white matter proton MRS at a mean of 7 d (range 1 - 17 d) after injury. We found that occipital gray matter ml levels were increased in children with TBI (4. 30 ± 0. 73) compared with controls (3.53 ± 0.48; p = 0.003) . We also found that patients with poor outcomes 6-12 mo after injury had higher ml levels (4.78 ± 0.68) than patients with good outcomes (4.15 ±0.69; p < 0.05) . Myoinositol is elevated after pediatric TBI and is associated with a poor neurologic outcome. The reasons for its elevation remain unclear but may be due to astrogliosis or to a disturbance in osmotic function.
