终池持续引流对急性重型颅脑损伤患者血浆中ET CGRP含量及脑血管痉挛指数的影响

Effect of terminal cistern continuous drainage on ET、CGRP in plasma and cerebral vessels spasm index of acute severe brain injury

目的 探讨终池持续引流对急性重型颅脑损伤患者血浆中内皮素 (ET)、降钙素基因相关肽 (CGRP)及脑血管痉挛指数的影响。方法 急性重型颅脑损伤患者 5 2例 ,随机分成 2组 ,终池持续引流组 2 6例 (A组 ) ,常规腰穿组 2 6例 (B组 ) ,正常对照组 12例 (C组 ) ,用放射免疫法测定A、B两组不同时点及C组的血浆中ET及CGRP的含量 ,同时行经颅多谱勒检查 ,检测痉挛指数。结果 第 1天A、B两组血浆中ET及CGRP含量无差异 (P >0 0 5 ) ,但两组ET含量均高于C组 (P <0 0 5 ) ,CGRP含量均低于C组 (P <0 0 5 ) ,第 1天A、B两组痉挛指数无差异 (P >0 0 5 ) ,但均高于C组 (P <0 0 5 ) ,第 3天ET含量B组高于A组 (P <0 0 5 ) ,A组高于C组 (P <0 0 5 ) ,CGRP含量B组低于A组 (P <0 0 5 ) ,A组低于C组 (P <0 0 5 ) ,痉挛指数B组高于A组 (P <0 0 5 ) ,A组高于C组 ,第 5天ET含量B组高于A组 (P <0 0 5 ) ,A组高于C组 (P <0 0 5 ) ,CGRP含量B组低于A组 ,A组低于C组 (P <0 5 ) ,痉挛指数B组高于A组 (P <0 0 5 ) ,A组低于C组 (P <0 0 5 ) ,第 7天ET含量B组高于A组 (P <0 0 1) ,A组略高于C组 ,但P >0 0 5 ,痉挛指数B组高于A组 (P <0 0 1) ,A组高于C组 (P <0 0 5 )。

Objective To investigate the treatment effect of terminal cistern continuous drainage on ET,CGRP in plasma and cerebral vessels spasm index of acute severe brain injury.Methods 52 patients were acute severe brain injury,and randomly divided into 2 groups:terminal cistern continuous drainage group was 26 cases (group A);routine lumbar puncture group was 26 cases (group B).Normal control group was 12 cases (group C).Radio-immunoassay was used to assay the different time endothelin(ET) and calcitonin-gene-related peptide(CGRP)of three groups in plasma, at the same time,to detect spasm index by transcraniodoppler examination.Results On the first day,the contents of ET and CGRP of group A and B in plasma were not different(P>0.05).But the contents of two groups were higher than that of group C(P<0.05).The spasm index of group A and B were different(P<0.05),but they were higher than group C(P<0.05).On the third day,ET was higher in group B than in group A(P<0.05),CGRP was lower in group B than in group A(P<0.05),spasm index was higher in group B than in group A(P<0.05),spasm index was higher in group A than in group C.On the fifth day,ET was higher in group B than in group A,P<0.05,group A was higher than C(P<0.05).CGRP was lower in group B than in group A,group A was lower than group C(P<0.05). Spasm index was higher in group B than in group A(P<0.05),group A was lower than group C(P<0.05).On the seventh day,ET was higher in group B than in group A(P<0.01),group A was slightly lower than C(P>0.05).CGRP was lower in group B than group A(P<0.01),group A was slightly lower than group C(but P>0.05).Spasm index was higher in group B than in group A(P<0.01),group A was lower than group C(P<0.05).Conclusion Terminal cistern continuous drainage was faster to reduce ET in plasma,make descending extent of CGRP quicker,apparently reduce spasm index of cerebral vessels,and had definite effect to relieve cerebral vessels spasm.