CAJ | 학술논문

目的观察持续腰大池引流对弥散性轴索损伤(diffuse axonal injury,DAI)患者脑脊液以及血浆中淀粉样β蛋白亚型(Aβ1-42)水平的影响及其临床意义.方法选择81例DAI患者并随机分为治疗组(42例)和对照组(39例).对照组采用常规治疗,治疗组在常规治疗基础上加用持续腰大池引流治疗14 d.采用ELISA法检测治疗前及治疗后l,5,9,14 d患者脑脊液和血浆中Aβ1-42水平,6个月后采用格拉斯哥预后评分(Glascow outcome scale,GOS)评定预后.结果两组患者脑脊液和血浆中Aβ142水平均先升高再逐渐降低,而治疗组Aβ1-42水平降低较早,幅度较大.治疗14 d后,两组Aβ1-42水平差异有统计学意义(P＜0.05).6个月后随访,治疗组GOS为(4.1±0.5)分,对照组为(3.4±0.3)分(P＜0.05).结论持续腰大池引流可改善DAI患者的预后,可能与其降低患者脑脊液及血浆中Aβ1-42水平有一定关系.
목적 관찰지속요대지인류대미산성축색손상(diffuse axonal injury,DAI)환자뇌척액이급혈장중정분양β단백아형(Aβ1-42)수평적영향급기림상의의.방법 선택81례DAI환자병수궤분위치료조(42례)화대조조(39례).대조조채용상규치료,치료조재상규치료기출상가용지속요대지인류치료14 d.채용ELISA법검측치료전급치료후l,5,9,14 d환자뇌척액화혈장중Aβ1-42수평,6개월후채용격랍사가예후평분(Glascow outcome scale,GOS)평정예후.결과 량조환자뇌척액화혈장중Aβ142수평균선승고재축점강저,이치료조Aβ1-42수평강저교조,폭도교대.치료14 d후,량조Aβ1-42수평차이유통계학의의(P＜0.05).6개월후수방,치료조GOS위(4.1±0.5)분,대조조위(3.4±0.3)분(P＜0.05).결론 지속요대지인류가개선DAI환자적예후,가능여기강저환자뇌척액급혈장중Aβ1-42수평유일정관계.
Objective To observe influence of continuous lumbar cistern drainage on levels of amyloid β-peptide (Aβ) subtype (Aβ1-42) in cerebrospinal fluid and plasma in patients with diffuse axonal injury (DAI) and investigate its clinical significance.Methods Eighty-one DAI patients were enrolled and randomized into treatment group (42 cases) and control group (39 cases).Patients in control group received simple conventional therapy,while the patients in treatment group received not only conventional therapy but 14 days of continuous lumbar cistern drainage.Levels of Aβ1-42 in cerebrospinal fluid and plasma were detected by ELISA assay before therapy and at 1,5,9,and 14 days after therapy.Prognosis was assessed using GOS at 6 months after therapy.Results Levels of Aβ1-42 in cerebrospinal fluid and plasma showed a decrease in the first place and a gradual decrease afterwards in both groups,but a bigger and earlier drop of Aβ1-42 levels was observed in treatment group.Two groups showed significant difference of Aβ1-42 levels at day 14 (P ＜ 0.05).At 6 months after therapy,GOS score between treatment and control groups was (4.1 ± O.5) and (3.4 ± 0.3) points respectively (P ＜0.05).Conclusion Continuous lumbar cistern drainage improves the prognosis of DAI and this may relates to the decrease of Aβ1-42 levels in cerebrospinal fluid and plasma.