SPECT及SOD检测在颅脑损伤患者中的应用

目的探讨超氧化物歧化酶（SOD）及单光子发射计算机体层摄影（SPECT）在评价颅脑损伤后病情和预后中的作用。方法选择符合要求的颅脑损伤患者60例，按照GCS评分标准分成轻型损伤组45例，中型损伤组8例和重型损伤组7例。20例健康员工为对照组。对人选的所有对象进行SPECT、CT扫描和SOD检测，其中颅脑损伤患者在伤后24h内和2周后进行SPECT和CT检查，伤后12h、24h、36h、48h、72h、1周、2周、1月和2-月抽取外周静脉血测定SOD含量。并对所有患者在伤后6月按GOS评价预后。结果入院初和伤后2周，对颅脑损伤患者SPECT检出阳性率要明显高于CT检出阳性率（P〈0．01），尤其对轻型损伤的患者更是如此．SPECT检出的颅脑损伤病灶数也比CT多。外周血SOD含量在伤后24h显著下降（P〈0．05），其中中型和重型损伤组SOD值下降最明显，直到1月后其值才恢复正常；伤后24h外周血SOD值与入院时GCS评分及伤后6月GOS评分呈正相关（P〈0.05）。结论颅脑损伤后早期进行SPECT和SOD的检测可以评价病情等级并可以对预后情况最出初步估计。

Value of Application of SPECT and Determination of SOD to Traumatic Brain Injury

Objective TO explore the role of single photon emission computed tomography (SPECT) and the serum level of superoxide dismutase (SOD) in evaluating the injury severity and prognosis in the patients with traumatic brain injury (TBI). Methods According to GCS, of 60 patients with TBI, 45 underwent mild TBI, 8 median TBI and 7 severe TBI. Twenty healthy subjects served as control. The examinations of heads with SPECT and CT were performed respectively within 24 hours and 2 weeks after TBI. The serum levels of SOD were determined 12, 24, 36, 48 and 72 hours, 1 and 2 weeks, and 1 and 2 months after TBI. The prognosis of the patients with TBI were evaluated 6 months after TBI. Results The detective rate of brain injury, especially mild injury, by SPECT was significantly higher than that by CT within 24 hours and 2 weeks after TBI (P<0.01). The serum level of SOD in mild TBI group was significantly lower than that in control group 24 hours after TBI (P<0.05), and the serum level of SOD in median and severe TBI groups were significantly lower than that in mild TBI and control groups 24, 36, 48 and 72 hours, and 1 and 2 weeks after TBI (P<0.05). The serum level of SOD 24 hours after TBI was positively related to the prognosis evaluated by GOS in the patients with TBI (P<0.05). Conclusion Early application of SPECT and determination of serum level of SOD are helpful to estimating the TBI severity and prognosis in the patients with TBI.