摘要
目的:观察持续腰大池引流对弥散性轴索损伤(DAI)患者脑脊液与血浆淀粉样β蛋白(Aβ)1-42水平的影响。方法:选择在我院治疗的96例DAI患者,随机分为研究组和对照组各48例。对照组行DAI的常规治疗,研究组在此基础上予腰大池持续引流2周,两组置管治疗后第1、5、9、14天留取血浆和脑脊液各2ml,比较两组血浆和脑脊液Aβ1-42的差异。治疗后6个月随访并进行格拉斯哥预后评分(GOS),比较两组患者的预后情况。结果:研究组和对照组患者在各时间点脑脊液和血浆的Aβ1-42水平均为先升高再降低,但研究组脑脊液Aβ1-42水平降低幅度较大,血浆Aβ1-42水平降低时间较早。治疗后第9、14天,研究组脑脊液及血浆Aβ1-42水平明显低于对照组(P<0.05)。研究组GOS较对照组高(P<0.05),预后情况较好。结论:持续腰大池引流有助于降低DAI患者脑脊液和血浆的Aβ水平,减轻其对神经细胞的毒害作用,改善患者的预后。
Objective： To observe the effects of continuous lumbar drainage in patients with diffuse on the cerebrospinal fluid and plasma amyloid （A）β1-42 protein levels. Methods： 96 cases of DAI randomly divided into study group （48 cases） and control group （48 cases）. All patients received axonal injury patients were conventional treatment of DAI, while the experimental group were also given continuous lumbar drainage. The drainage lasted 2 weeks. 2 ml plasma and cerebrospinal fluid were sampled in each patient in the experimental group on day 1,5,9 and 14 of treatment. The differences of the two groups were compared. All the patients were followed up for 6 months and underwent Glasgow Outcome Scale（GOS） ,finally their prognosis was compared. Results： The CSF Aβ1-42 levels in all the patients first increased and then decreased, but the magnitude of reduction was larger in the experimental group. On day 9, 14 days after treatment, cerebrospinal fluid and plasma levels of A fll-42 was significantly lower in the experimental group than that the control group （P 〈 0. 05 ）. The GOS of the experimental group were higher than the control group and the prognosis was better （P 〈 0.05 ）. Conclusion： Continuous lumbar drainage helps to reduce levels of amyloidβ protein in the cerebrospinal fluid and plasma of patients with diffuse axonal injury, mitigating its toxic effects on nerve cells and improving patient outcomes.
出处
《现代医学》
2015年第4期427-431,共5页
Modern Medical Journal
关键词
持续腰大池引流
弥散性轴索损伤
脑脊液
血浆
淀粉样Β蛋白
continuous lumbar drainage
diffuse axonal injury
cerebrospinal fluid
plasma
amyloid β protein
