摘要
目的 研究重型颅脑外伤后脑脊液中内皮素（ＥＴ－１）和一氧化氮（ＮＯ）浓度变化及其与外伤性蛛血ＣＴ表现的关系。方法 重型脑外伤病人３０例，入院时ＧＣＳ小于８分。入院后均行头颅ＣＦ检查并根据ＣＴ蛛血表现进行Ｆｉｓｈｅｒ分级；于入院后２４ｈ及３，５，７ｄ进行脑脊液ＥＴ－１、ＮＯ浓度测定。结果 颅脑外伤后各组病人脑脊液中ＥＴ浓度均明显高于正常组，伤后第３ｄ达到高峰；Ｆｉｓｈｅｒ Ⅱ，Ⅳ病人组之间脑脊液中ＥＴ浓度无显著差异；Ｆｉｓｈｅｒ Ⅲ组病人脑脊液中ＥＴ浓度与Ｆｉｓｈｅｒ Ⅱ，Ⅳ病人组之间存在显著差异；颅脑外伤后各组病人脑脊液中ＮＯ浓度均明显低于正常组，伤后第３ｄ抑制最明显；Ｆｉｓｈｅｒ Ⅱ，Ⅳ病人组之间脑脊液中ＮＯ浓度未见差异；Ｆｉｓｈｅｒ Ⅲ组病人脑脊液中ＮＯ浓度伤后第１，３，５ｄ与Ｆｉｓｈｅｒ Ⅱ，Ⅳ病人组之间存在显著差异；第７ｄ与Ｆｉｓｈｅｒ Ⅱ，Ⅳ病人组之间虽未见差异，但仍低于Ｆｉｓｈｅｒ Ⅱ，Ⅳ组。结论 颅脑外伤后多种因素均可造成脑脊液ＥＴ浓度升高，ＮＯ抑制，而严重外伤性蛛血病人蛛网膜下腔中氧合血红蛋白的刺激进一步加重上述平衡破坏，从而可能引起缺血性神经功能障碍。
Objective To elucidate endothelin and nitric oxide concentration in patients with severe head injury and their relationship with severity of traumatic subarachnoid hemorrhage. Methods Thirty patients suffering from severe head injury were included into our study with GCS less than 8. Concentrations of ET and NO in cerebrospinal fluid were measured serially in day 1 、3 、5 、7 after head in- jury, and compared with those of the normal volunteers. Fisher grades of all patients were determined by CT scanning. Results In patients with severe head injury, CSF concentrations of ET and NO were significantly different to those of the normal volunteers, meanwhile their concentrations in patients with Fisher Ⅲ were different to those with Fisher Ⅱ and Ⅳ statistically, although there was no statistical difference between patients with Fisher Ⅱ and Ⅳ. Conclusion We think that many mechanisms after severe head injury will cause the increase of ET concentration and decrease of NO concentration in patients' CSF, and severe traumatic SAH may destroy ET/NO balance and induce ischemic neurological disturbance.
出处
《上海第二医科大学学报》
CSCD
2001年第3期217-219,共3页
Acta Universitatis Medicinalis Secondae Shanghai
