重型颅脑损伤患者脑脊液SBDPs的水平变化

目的探讨重型颅脑损伤患者脑脊液中αⅡ血影蛋白裂解产物（SBDPs，包括SBDP140和SBDP120）浓度与颅脑损伤的程度和患者预后的关系。方法选择40例重型颅脑损伤（Gcs≤8分）患者（颅脑损伤组），伤后6h、12h、24h、1d、2d、3d、4d、5d．6d．7d取脑脊液采用酶联免疫吸附法检测SBDP140和SBDP120浓度；选择24例脑积水患者作为对照组。结果不同时间点颅脑损伤组脑脊液SBDP145和SBDP120浓度均明显高于对照组（P〈0.05），SBDP145在伤后6h就达最高峰，而SBDP120直到到伤后5d才达峰值。不同时间点伤后3个月死亡的颅脑损伤患者脑脊液的SBDP145和SBDP120浓度明显高于生存的患者（p〈0．05）。入院时GCS评分6—8分患者脑脊液离脊液SBDP145的浓度明显低于入院时GCS评分3-5的患者（P〈0．05），而SBDP120的浓度两者之间无明显变化（P〉0．05）。结论颅脑损伤患者脑脊液SBDPs与颅脑损伤的严重性和患者预后有关。

Change in levels of SBDPs in cerebrospinal fluid and their meaning in patients with severe traumatic brain injury

Objective To explore the changes in the levels ofαⅡ-speetrin breakdown products （SBDPs） in cerehrospinal fluid （CSF） in the patients with severe traumatic brain injury （TBI） and their relatienships with the severity of TBI and prognoses. Methods CSF levels of SBDP 120 and SBDP145 were determined by enzyme linked immunoserbent assay 0.25, 0.5, 1, 2, 3, 4, 5, 6 and 7 days after TBI in 40 adult patients with severe TBI （GCS≤8） and 24 patients with hydrocephalus serving as control group. The relationship of the changes in the CSF levels of SBDP 120 and SBDP145 with the TBI severity and prognoses were analyzed. Results CSF levels of SBDPs were significantly higher 0.25, 0.5, 1, 2, 3, 4, 5, 6 and 7 days after TBI in TBI group than that in the control group （P〈0.05）. The levels of SBDP145 reached the top 6 hours after the injury, and the levels of SBDP120 reached the top 5 days after the injury. The levels of SBDP145 were significantly higher in TBI patients with GCS 3-5 points than those in TBI patients with GCS 6-8 points （P〈0.05）. The levels of SBDP120 and SBDP145 were significantly higher in TBI patients who died than those in TBI patients who survived. Conclusions It is suggested that SBDPs levels in CSF may be helpful to predicting the prognoses in the patients with severe TBI.