重型颅脑损伤患者血清及脑脊液胃泌素水平测定及其意义

目的探讨重型颅脑损伤患者血清及脑脊液胃泌素水平与颅脑损伤程度及其与消化道出血的关系，探讨血清与脑脊液胃泌素含量的相关性。方法对71例重型颅脑损伤患者，根据伤后是否合并消化道出血分为出血组及无出血组，用放射免疫法分别于入院时及第3、7、14天测定血清及脑脊液胃泌素含量并与正常对照组进行比较。结果重型颅脑损伤早期血清胃泌素含量均明显．高于正常对照组（P〈0．01）；3～7d达高峰，伤后1周内有、无出血组间差异显著（P〈0．01）；随着病情好转，血清胃泌素值逐渐下降，伤后2周，出血组血清胃泌素水平明显高于无出血组（P〈0．01）。脑脊液胃泌素不能检出。结论血清胃泌素水平与颅脑损伤程度及消化道出血呈正相关，脑脊液胃泌素水平测定与颅脑损伤程度及消化道出血无相关性，血清与脑脊液胃泌素含量无相关性，早期动态观察血清胃泌素含量变化对判断病情及预后有重要意义。

Study on significance of serum and CSF levels of gastrin in patients with severe head injury

Objective To evaluate serum and cerebral spinal fluid（CSF） levels of gastrin in patients with severe head injury, to define its relationship with degrde of severe head injury and digestive tract hemorrhage and to explore the relationship belween serum and CSF levels of gastrin. Methods Seventy one patients with severe head injury are divided into hemorrhage group and non - hemorrhage group according to whether the patient had hemorrhage of digestive tract or not. The serum and CSF levels of gastrin are examined with radioimmunoassay in the 3rd, 7th and 14th days after admission, and their figures are compared with those of control group. Results Serum levels of gastrin in patients with early stage of severe head injury are significantly higher than those of control group （ P 〈0.01 ） and serum level reached at peak within 3 to 7 days, the difference is significant in one week between patients of hemorrhage group and non - hemorrhage group（ P 〈0.01 ）. Following the recovery of disease, the serum level of gastrin is gradually decreased, but serum level of gastrin in patients of hemorrhage group is still significantly higher than that of non - hemorrhage group at 2 weeks later（ P 〈 0.01 ）. CSF serum level is 0 ng/L. Conclusion Serum level of gastrin has positive correlation with the severity of head injury and digestive tract hemorrhage. There is no correlation in CSF level of gastrin between degree of head injury and digestive tract hemorrhage. Serum level of gastrin is not closely related to its CSF level. Early dynamic observation on the change in serum levels of gastrin is very important in estimating the severity and prognosis of patients with head injury.