急性颅脑损伤后脑脊液抑制性氨基酸的变化及意义

目的探讨脑脊液中抑制性氨基酸的水平与颅脑损伤严重程度的关系。方法将71例急性颅脑损伤患者按入院时GCS评分分为9~15分组（37例）和3~8分组（34例）,伤后1、3、7 d采集脑脊液标本;以28例正常脑脊液标本作对照组。采用柱前衍生反相高效液相色谱紫外吸收检测法定量分析脑脊液标本中γ-氨基丁酸（GABA）、牛磺酸（Tau）和丙氨酸（Ala）浓度。结果颅脑损伤后脑脊液GABA、Tau浓度均高于对照组,GCS 3~8分组Tau浓度均明显高于GCS 9~15分组（P〈0.05）。颅脑损伤后1、7d,GCS 3~8分组GABA浓度高于GCS 9~15分组（P〈0.05）,伤后3 d时两组浓度无显著性差异（P〉0.05）。颅脑损伤后Ala浓度较对照组明显下降（P〈0.05）。结论脑脊液GABA、Tau在颅脑损伤后反应性增高提示其可能与颅脑损伤的严重程度相关。脑脊液Ala浓度在颅脑损伤后下降提示颅脑损伤后部分脑保护机制受到损害。

Change in cerebrospinal fluid inhibitory amino-acid in the patients with acute traumatic brain injury

ObjectiveTo study the relationship between change in inhibitory amino-acid in cerebrospinal fluid（CSF） and theseverity of acute traumatic brain injury（TBI）.MethodsSeventy-one patients with acute TBI were divided into group A（GCS 3~8, n=34）and group B（GCS 9~15, n=37） according GCS on admittance to hospital. The contents of taurine（Tau）, γ-aminobutyric acid（GABA）and alanine（Ala） in all the patients CSF, which was collected 1, 3 and 7 days after TBI, and 28 normal CSF samples collected fromhealthful subjects serving control were determined by reserved phase high performance liquid chromatography ultraviolet detectionwith precolumn derivatization.ResultsCSF contents of Tau and GABA were significantly higher in groups A and B 1, 3 and 7 days afterTBI than those in the control group（P〈0.01）. CSF contents of Tau were significantly higher in group A than those in group B 1, 3 and 7days after TBI（P〈0.01）. CSF contents of GABA were significantly higher in group A than those in group B 1, 3 and 7 days after TBI（P〈0.01）. CSF content of Ala in group A 7 days after TBI and CSF contents of Ala in group B 1, 3 and 7 days after TBI were significantlylower than those in the control group（P〈0.05）.ConclusionTau and GABA contents in CSF after TBI are positively related to theseverity of TBI.