颅脑手术创伤对脑脊液兴奋性氨基酸和甘氨酸代谢的影响

目的　观察颅脑手术创伤对脑脊液兴奋性氨基酸 (EAA )和甘氨酸 (Gly)代谢的影响 ,为手术麻醉过程中如何减少 EAA和 Gly提供理论依据。　方法　于腰椎 3～ 4间隙行蛛网膜下腔穿刺置硬膜外导管长度约 3cm ,分别于麻醉 (BA)、手术结束缝皮时 (PA )采集脑脊液标本 2 m L。采用高效液相色谱仪柱前衍生色谱法 (HPL C)测定颅脑手术前后、脑实质和非脑实质手术、不同手术时程 3种条件下脑脊液中 EAA(谷氨酸 (Glu)、天冬氨酸 (Asp)和甘氨酸 (Gly)水平变化。　结果　 EAA在颅脑手术后明显升高 (P<0 .0 5 ) ;对脑组织有直接侵袭损伤类手术于术后 EAA (Glu、Asp)和甘氨酸 (Gly)显著升高 ,且手术时程长者 (>2 h)脑脊液 EAA和 Gly升高幅度更大。　结论　脑脊液 EAA和 Gly水平显著增高的主要原因是直接侵袭脑组织的脑内手术 ,且升高幅度与手术时程长短有关 ,非脑实质手术组的改变不明显

Effects of Injury Caused by Cerebral Operation on Excitatory Amino Acid and Glycine Metabolism in Cerebrospinal Fluid

Objective To observe the effects of injury caused by cerebral operation on excitatory amino acid(EAA) and glycine(Gly) of cerebrospinal fluid. Methods Epidural catheters of about three|centimeter were put on subarachnoid space through lumbar vertebrae 3|4 interspace. Cerebrospinal fluids of two|cubic centimeter were respectively collected before anesthesia and post operation at sewing skin. Proper sulfosalicylic acids were added in cerebrospinal fluid samples to remove the protein. The level of the glutamic acid, asparagic acid and glycine in cerebrospinal fluid were measured with high performance liquid chromatography(HPLC). Results The level of EAA step up significantly after operation. The level of EAA and Gly step up significantly after operation according to the kind of operation which directly give damage to the brain tissue, moreover the stepping|up range of the EAA and Gly was positively correlated to the hours of operation. Conclusion The stepping|up level of EAA and Gly in cerebrospinal fluid are mainly caused by the kind of intracerebral surgery which directly gives damage to the brain tissue and the range of stepping|up EAA and Gly is correlated to the hours of the operation.