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脑梗死后血、脑脊液中兴奋性氨基酸变化与神经功能缺失的关系 被引量:15

The relation between dynamic changes of excitatory amino acids in blood and cere brospinal fluid and neurological functional defect in patients with cerebral inf arction
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摘要 目的:观察脑梗死患者血和脑脊液(CSF)中兴奋性氨基酸浓度的动态变化,并探讨其变化规律及临床意义。方法:采用高效液相色谱法检测了32例正常对照组和86例脑梗死患者起病后6h~10d的血及CSF中谷氨酸(Glu)和甘氨酸(Gly)浓度的变化。结果:脑梗死组Glu和Gly的浓度在6h后已开始升高,24h明显升高犤CSF中Glu(62.8±25.9)μmol/L,t=4.71,P<0.01,Gly(82.1±24.5)μmol/L,t=3.52,P<0.01;血中Glu(134.1±25.3)μmol/L,t=3.07,P<0.05,Gly(195.1±27.1)μmol/L,t=3.03,P<0.05犦。二三天达高峰犤CSF中,Glu(78.1±14.2)μmol/L,t=7.26,P<0.01,Gly(106.0±26.3)μmol/L,t=5.95,P<0.01;血中Glu(146.3±6.4)μmol/L,t=14.43,P<0.01,Gly(248.1±12.5)μmol/L,t=16.69,P<0.01犦。3d后渐下降,7~10d后基本接近正常。同时还发现脑梗死后血及CSF中Glu浓度呈正相关(r=0.826,P<0.01)。CSF中Glu浓度的变化与梗死灶的直径和神经功能缺失评分也呈正相关(r=0.628,P<0.01,r=0.718,P<0.01),而与病程呈抛物线型相关(3d前r=0.806,P<0.01呈显著正相关,3d后r=-0.382,P<0.05呈负相关)。结论:动态观察血和CSF中Glu和Gly的浓度变化,可作为临床观察病情变化和判断预后的敏感指标。 AIM:To observe the dynamic changes of excitatory amino acids in blood and cere brospinal fluid (CSF) in patients with cerebral infarction, and to probe the law of change and its clinical significance. METHOD:High performance liquid chromatography was used to detect the levels of glutamic acid (Glu) and glycine (Gly) in blood and CSF. Samples were taken from 86 cases of patients with cerebral infarction within 6 h-10 d after episode an d 32 healthy persons were detected as controls. RESULTS:Concentrations of Glu and Gly began to increase after 6 h, to increase significantly after 24 h [in CSF,the concentrations of Glu and Gly were (62.8 ±25.9) and (82.1±24.5) 靘ol/L (t=4.71, P< 0.01; t=3.52, P< 0.01);in blood, t he concentrations were (134.1±25.3) and (195.1±27.1) 靘ol/L (t=3.07, P< 0.05; t=3.03, P< 0.05)], reached the peak at the second or third day [in CSF,the con centrations were (78.1±14.2) and (106.0±26.3) 靘ol/L (t=7.26, P< 0.01;t=5.95, P< 0.01);in blood, the concentrations were (146.3±6.4) and (248.1±12.5) 靘ol/L (t=14.43, P< 0.01;t=16.69, P< 0.01)], decreased gradually after 3 d, and afte r 7-10 d they returned to the normal levels. The concentration of Glu in blood and in CSF after cerebral infarction was correlated positively (r=0.826, P< 0.0 1).The levels of Glu in CSF was positively correlated significantly with the di ameter of the infarction site and neurological functional defect scales (r=0.628 ,P< 0.01,r=0.718,P< 0.01), but the level of Glu had parabola’s correlation with the courses of disease (before 3 d,r=0.806,P< 0.01 positively correlated; after 3 d,r=-0.382,P< 0.05 negatively correlated).
出处 《中国临床康复》 CSCD 2003年第25期3422-3423,共2页 Chinese Journal of Clinical Rehabilitation
基金 河南省教育厅资助项目(98320025)~~
关键词 脑梗死 兴奋性氨基酸 谷氨酸 甘氨酸 神经功能缺损 The Glu and Gly play the important roles in the pathologic process of cerebral infarction .The concentrations of Glu and Gly in blood and CSF are t he sensitive index for the clinical observation and diagnosing the prognosis of the diseases.
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