痉挛性脑瘫患儿脑脊液胆碱酯酶的研究

Cholineterase in cerebral spinal fluid of children with cerebral palsy

目的 研究痉挛性脑性瘫痪 (CP)患儿肌痉挛形成机制及选择性脊神经后根切断术 (SPR)治疗机制。方法 采用改良的 Ellman法测定 45例痉挛性脑瘫患儿 ,3 0例非神经系统疾病儿童及 18例 SPR术后脑瘫患儿脑脊液中乙酰胆碱酯酶 (Ach E)和丁酰胆碱酯酶 (Bch E)的水平。结果 SPR术前脑瘫组脑脊液 Ach E明显低于对照组 ,且与病情程度相关 ,Bch E和对照组无显著差异 ;SPR术后脑瘫患者脑脊液 Ach E比术前明显升高 ,Bch E与术前无显著差别。结论 痉挛性脑瘫患儿胆碱能神经元功能降低可能在痉挛性脑瘫肌痉挛及智力障碍的形成中起重要作用 。

Objective To investigate the mechanism of spastic ity in cerebral palsy (CP) and the mechanism of selective posterior rhizotomy (SPR)in treating CP.Methods Cerebrospinal fluid was obtained from spastic cerebral palsy group(n=45),control group (those without central nervous system pathology,n=30) and the operated group( those were underwent SPR,n=18).The concentrations of acetylcholineterase(AchE) and butyrylcholin eterase(BchE) in cerebral palsy were determined by improved Ellman method.Results Prior to SPR,the level of AchE in CP group was significantly lower than the control,the level of BchE had no significant diffirence with the control,and AchE was correlated positively with condition of patient.After SPR,the level of AchE was significantly higher than preoperative,the level of BchE has no significant diffirence topreoperative.Conclusion The decrease of cholinergic neuron pro bably plays an important role in spasticity of cerebral palsy.After SPR,the increase of cholinergic neuron is associated with the release of spasticity and the improvement of whole body's symptom.