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脑损伤患者的康复结局与血清谷氨酸水平的相关性研究 |
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汪平 郭正成
摘 要：目的 探讨脑外伤患者的康复结局与血清谷氨酸(GLU)水平的相关性。 方法 采用高效液相色谱法（HPLC）测定30例急性脑外伤患者伤后24 h内和6 d的血清谷氨酸，并在24 h内采用格拉斯哥昏迷计分（GCS）及20 d后功能独立性（FIM）的评定值进行相关性研究。 结果 血清GLU（24 h内）的水平和GCS、FIM得分呈良好的负相关。将24 h测量的血清GLU浓度与6 d血清GLU浓度值比较,分为持续增高组与降低组。两组20 d后的FIM平均得分有显著性差异(P<0.01)，GLU浓度持续增高组的FIM得分远远低于GLU浓度降低组。 结论 脑外伤患者血清GLU浓度可影响脑组织的继发性损伤程度，并影响患者功能的恢复。
关键词：谷氨酸； 脑损伤； 色谱法，高压液相； 格拉斯哥昏迷计量表； 功能独立测量表
Correlation between plasmatic glutamic acid level and rehabilitation of patients with brain injury
WANG Ping GUO Zhengcheng.
（Dept. of Rehabilitation, Suzhou NO.4 People s Hospital, Suzhou 215001, China）
Abstract：Objective To study correlation between plasmatic glutamic (GLU) acid level with rehabilitation of patients with brain injury. Methods By high－performance liquid chromatography, we determined the plasmatic glutamic acid concentration of patients within 24 hours and 6 days after brain injury and made relative analysis with Glasgow coma scale (GCS) within 24 hours and function independence measure (FIM) after 20 days. Results The concentration of plasmatic glutamic acid within 24 hours was well negatively correlated to GCS and FIM. A comparison of the concentration of plasmatic glutamic acid in 24 hours and that in 6 days showed two different groups, i.e. GLU concentration continuous increase group and GLU concentration decrease group. There was a significant difference (P<0.01) that FIM score in the GLU concentration increase group was far lower than that of the GLU concentration decrease group according to mean score of FIM after 20 days in two groups. Conclusions The concentration of glutamic acid in patients plasma effects secondary cerebral damage and recovery of patients.
Key words：Glutamic acid; Brain injuries； Chromatography， high pressure liquid; Glasgow coma scale； Function independence measure▲
脑外伤后一系列生化改变不仅能使患者遭受时间长短和程度不等的神经功能障碍，而且也是导致脑外伤患者死亡的重要原因。近年来，兴奋性氨基酸（EAA）对大脑的兴奋性毒性已得到公认，许多研究表明脑[1] [2] 下一页
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