急性缺血性卒中患者血浆和脑脊液中谷氨酸测定及其临床应用价值

• 作 者: 何明利 陈曼娥 王景周
• 机 构: 四川省达川地区人民医院!四川达川635000,第三军医大学大坪医院野战外科研究所!重庆400042,第三军医大学大坪医院野战外科研究所!重庆400042
• 出 处: 中国危重病急救医学
• 发表日期: 1999年09期
• 关键词: 急性缺血性卒中 急性 急性脑梗死 进展性卒中 神经功能缺失 临床应用 患者体液 颈内动脉阻塞

目的：探索稳定性和进展性急性缺血性卒中患者体液中谷氨酸（ Ｇｌｕ）升高的时限。方法：应用高效液相色谱分析检测１２８ 例首次发病的急性脑梗死（ Ａ Ｃ Ｉ）患者发病１～７ 日的血浆 Ｇｌｕ、脑脊液（ Ｃ Ｓ Ｆ） Ｇｌｕ 浓度的变化，并与同期检测的神经功能缺失程度（ Ｃ Ｓ Ｓ积分）、脑梗死容积（ Ｃ Ｔ Ｖ）进行相关分析。结果：１２８ 例 Ａ Ｃ Ｉ患者的平均血浆 Ｇｌｕ、 Ｃ Ｓ Ｆ Ｇｌｕ 浓度分别为（１３６２９±３２５３）ｍ ｍ ｏｌ／ Ｌ和（６４８±３２９）ｍ ｍ ｏｌ／ Ｌ，均显著高于对照组〔（１２９２０±２８１５）ｍ ｍ ｏｌ／ Ｌ和（３０９±１４８）ｍ ｍ ｏｌ／ Ｌ， Ｐ＜ ００５ 和 Ｐ＜ ０００１〕；进展性 Ａ Ｃ Ｉ组平均 Ｃ Ｓ Ｆ Ｇｌｕ 浓度为（６４７±１３２）ｍ ｍ ｏｌ／ Ｌ，极显著高于稳定性 Ａ Ｃ Ｉ组〔（５３２±１０７）ｍ ｍ ｏｌ／ Ｌ， Ｐ＜ ０００１〕；稳定性组 １～７ 日各时间点的血浆 Ｇｌｕ 浓度无显著变化，而进展性 Ａ Ｃ Ｉ组于发病 ４ 日内的血浆 Ｇｌｕ 浓度进行性升高； Ｃ Ｔ Ｖ≥１０ ｃｍ ３ 组平均 Ｃ Ｓ Ｆ Ｇｌｕ 浓度为（６７４±１３７）ｍ ｍ ｏｌ／ Ｌ，极显著高于 Ｃ Ｔ Ｖ＜ １０ ｃｍ ?

OBJECTIVE: To explore the duration of glutamate (Glu) increase in body fluids of patients with stable and advanced acute ischemic stroke. Methods: The changes of plasma Glu and CSF Glu concentrations in 128 patients with acute cerebral infarction (ACI) from the first to the seventh day after onset were detected by HPLC. (C S S integral), cerebral infarction volume (C T V) were analyzed. Results: The average plasma concentrations of Glu and CSF Glu in 128 patients with A C I were (13629 ± 3253) m mol / L and (6  48 ± 329) m mol / L respectively, (12920 ± 2815) m mol / L and (309 ± 1.48) m ol / L respectively, P <005 and P <0001〕. The average C F Glu concentration in progressive A C I group was (647 ± 132) m mol / L, which was significantly higher than that in the stable A C I group [(532 ± 107) m m ol / L, P <0001〕. In the stability group, there was no significant change in the plasma Glu concentration at each time point between the 1st and 7th day, while in the progressive A CⅠ group, plasma Glu concentration increased progressively within 4 days after the onset. The average concentration of C S F Glu in T V≥10 cm 3 group was (674 ± 137) m mol / L, which was significantly higher than that in C T V <10 cm?