脑损伤病人血浆、脑脊液中一氧化氮含量周期变化的研究

目的 测定脑损伤病人伤后早期血浆、脑脊液中NO的含量，阐述一氧化氮（NO）对脑损伤病人继发损害的生物学作用。方法 选取伤后24h内入院的病人56例，采用改进的Griess法测定伤后24、48、72、168h血浆，脑脊液中NO含量。结果 脑损伤病人伤后24h内血浆，脑脊液中NO即开始明显升高，在72h内达到峰值，到168h基本降至正常，脑损伤病人轻、中、重型组各组之间NO含量均有显著差异。损伤越重，NO含量越高，除了脑震荡外，不同损伤类型间NO含量无显著差异。在损伤类型和损伤程度具有可比性的情况下，手术治疗组和保守治疗组NO含量无显著差异。结论 脑损伤病人体内NO含量确定发生明显的变化。它的变化趋势和变化程度与病人的损伤程度和预后又直接相关。证实NO参与了脑损害且发挥着重要作用。提示通过测定血浆，脑脊液（尤其脑脊液）中NO含量可以判断脑损伤程度，治疗效果和预后。

Clinical significance of the periodic changes of NO concentration in plasma and CSF in traumatic cerebral injury

Objective To study the biological action of nitric oxide in the secondary injury by measuring NO concentration in plasma and CSF of the patients with cerebral injury.Methods NO concentration in plasma and CSF within 24,48,72,168 h postinjury respectively was measured by means of the improved Griess method.Results NO concentration in plasma and CSF of the patients with cerebral injury within 24 h increased obviously,peaking within 72 h,decreasing to the normal level within 168 h.It was statistically significant between severe type and slight,middle type.However,it was no different between various groups except contusion group.Conclusion NO concentration of the patients with cerebral injury had changed,which trend and extent of change were directly correlative with injury extent and prognosis.It proved that NO took part in the secondary injury of cerebral injury and played an important role in it.This implied that injury severity,therapeutic outcome and prognosis could be accurately judged by measuring NO concentration in CSF.