脊髓损伤患者血清及脑脊液中髓鞘碱性蛋白的动态变化及意义

目的：研究急性脊髓损伤后血清、脑脊液髓鞘碱性蛋白（MBP）的动态变化与脊髓损伤程度、预后情况之间的关系。方法：ELISA法检测47例不同程度脊髓损伤患者伤后不同时间血清和脑脊液MBP含量，结合预后程度进行分析。结果：脊髓完全性损伤组病人伤后12h内即出现脑脊液MBP显著增高，伤后3d达高峰，并持续至伤后第14d，脊髓不完全性损伤组伤后，12h内也出现脑脊液MBP增高，高峰亦为伤后第3d，但各时间点增高幅度较完全性损伤组小，且伤后第14d时即恢复正常；脊髓震荡组不出现脑脊液MBP增高；各组血清检测结果与脑脊液结果平行。结论：血清和脑脊液MBP检测对于判断脊髓损伤程度、估计预后特别是骨髓损伤休克期选择正确的治疗方法具有积极的意义。

Dynamical Assays for Myelin Basic Protein in Serum and Cerebrospinal Fluid of Patients with Spinal Cord Injury and Its Clinical Significance

Objective:To study the relationship between the dynamical change of myelin basic protein (MBP) in serum and cerebrospinal fluid of patients with acute spinal cord injury and their severity and prognosis.Methods:Serum and CSF level of MBP were measured in 47 patients at different time (12h,36h,3d,7d,14d,21d)after acute spinal cord injury by ELSA.The severity of spinal cord injury were retrospectively evaluated in terms of recovery 6 months after injury.Results:Mean serum and CSF concentration of MBP in patients with complete spinal cord injury raised significantly within 12h after injury.then mounted up to summit by the time of 3d after injury,and remained high for 14d compared with those in controls.As well as in patients with incomplete spinal cord injury.MBP raised within 12h after injury and mounted up to summit by the time of 3d after injury.But the concentration were lower and the persistence time was more brief compared with those in patients with complete spinal cord injury.While in patients with spinal cord concussion.MBP did not raise at any time.The serum concentration was parallel to that of CSF all the time.Conclusion:Dynamical assays for myelin basic protein in serum and CSF of patients with spinal cord injury are helpful for assessment their severity and prognosis.