急性脑梗死患者血、脑脊液兴奋性氨基酸的变化与意义

目的 研究急性脑梗死后谷氨酸（Glu)、甘氨酸（Gly)的变化规律及与梗死恶化进展的关系。方法 采用高效液相色谱技术测定112例发病24h内的急性脑梗死患者及32例正常对照组血和脑脊液（CSF）中Glu、Gly浓度的变化。结果 脑梗死患者血和CSF中Glu、Gly浓度在发病24h内明显升高，其变化与神经功能缺损程度呈显著相关。恶化进展性脑梗死Glu、Gly浓度较稳定性脑梗死升高更为显著。结论 Glu和Gly在脑梗死的发生、发展过程中起着重要作用，血和CSF中Glu、Gly浓度不仅与发病24h内神经功能缺损程度有关，并可作为脑梗死后48h病情恶化进展的一个临床观察直接客观的指标。

Meaning of excition amino acids measurements for predicting the deterioration of patients with acute cerebral infarction

Objective To study the relationship between the levels of Glu and Gly and the deterioration of patients with acute cerebral infarction. Methods High performance liquid chromatography (HPLC) was used to detect the levels of Glu and Gly in blood and CSF. The samples were taken from 112 cases of patients with acute cerebral infarction within 24 hours after the ictus. At the same time, 32 healthy persons were detected as the normal control. Results Concentrations of Glu and Gly in both blood and CSF were significantly high within 24 hours after the ictus. Furthermore, the levels correlated significantly with their neurological functional defects. The levels of patients with progressive cerebral infarction were higher than those of patients with stable cerebral infarction. Conclusions The Glu and Gly played the important roles in the pathologic process of cerebral infarction. The levels of Glu and Gly in both blood and CSF not only correlated with corresponding neurologic functional defects within 24 hours after the ictus but also could be looked as a subjective clinical marker of deterioration within 48 hours after the ictus.