血清镁水平与颅脑损伤严重程度的关系及其对预后的影响

目的研究血清镁水平与颅脑损伤严重程度的关系及早期补充硫酸镁对颅脑损伤患者预后的影响。方法检测231例颅脑损伤患者入院时的血清镁浓度，并将其中116例重型颅脑损伤患者随机分为硫酸镁治疗组及对照组，每组各58例。治疗组除常规治疗外还给予硫酸镁2g（16mmol）稀释至100ml于15min内推注＋硫酸镁7．8g（65mmol）稀释至500ml静滴24h。对照组仅给予常规治疗。检测两组患者入院时及人院第3天时血清镁浓度．入院时和入院1周时的血清神经元特异烯醇化酶（NSE）浓度，6个月后按GOS进行预后评价。结果重型颅脑损伤与轻中型颅脑损伤患者入院时的血镁浓度无显著差异（P〉0．05），低血镁组和高血镁组入院时GCS无显著差异（P〉0．05）。治疗组和对照组的重型颅脑损伤患者在伤后1周时的血清NSE水平及伤后6个月时的GOS均无显著差异（P〉0．05）。结论本研究未发现颅脑损伤后早期患者血镁浓度与其伤情间的必然联系，早期补充硫酸镁也未能明显改善重型颅脑损伤患者的治疗结果。

Relationship of Serum Magnesium Level with Severity of Craniocerebral Injury and Its Effect on Prognoses in Patients with Traumatic Brain Injury

Objective To explore the relationship of the serum magnesium level with the injurious severi;y and its effect on prognoses in patients with traumatic brain injury （TBI）. Methods The serum levels of magnesium and neuron specific enolase （NSE） were determined immediately after admission into hospital and its relationship with the injurious severity was analyzed in 231 patients with TBI. One hundred and sixteen patients with severe TBI were randomly divided into MgSO4 group （58 patients）, where the patients were treated by MgSO4 besides routine treatment, and control group （58 patients）, where the patients were routinely treated. The serum levels of magnesium 3 days after TBI and the serum level of NSE 7 days after TBI were determined in both the groups. The prognoses which were assessed by GOS 6 months after TBI was compared between both the groups. Results There was insignificant difference in the serum levels of magnesium between the patients with severe TBI and ones with mild and medium TBI （P〉0.05）. There were insignificant differences in the serum levels of NSE 7 days after TBI and in GOS 6 months after TBI between both MgSO4 group and the control group （P〉0.05）. Conclusion It is suggested that there is insignificant relativity of the serum levels of magnesium with the injurious severity in the patients with TBI. There is insignificant effect of treatment with MgSO4 early after TBI on the prognoses in the patients with TBI.