脑损伤后脑细胞外液中糖代谢变化的微透析研究  

Changes in Glucose Metabolism of Extracellular Fluid Following Traumatic Brain Injury: a Microdialysis Study

作　　者：万登峰[1] 陈劲草[2] 古金海[3] 薛德麟[2] 

机构地区：[1]华中科技大学同济医学院附属同济医院神经外科(现在江西省人民医院神经外科(江西南昌,330006 [2]华中科技大学同济医学院附属同济医院神经外科 [3]江西省人民医院神经外科

出　　处：《中国临床神经外科杂志》2004年第6期404-406,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨微透析技术监测脑损伤局部细胞外液(ECF)中糖代谢指标变化的意义。方法应用微透析技术动态收集大鼠轻、重度脑损伤局部的ECF透析液,观察其葡萄糖含量([Glu]d)和乳酸含量([Lac]d)的变化。结果透析管插入引起[Glu]d和[Lac]d的变化很小(P>0.05)。脑损伤后[Glu]d下降,与对照组及损伤前相比,相差显著(P<0.05),且损伤越重其变化越显著(P<0.05)。而脑损伤后[Lac]d则上升,与对照组及损伤前相比,相差显著(P<0.05),且损伤越重,其变化亦越显著(P<0.05)。脑损伤后[Glu]d和[Lac]d的变化分别与脑组织含水量呈显著负相关(P<0.05)和显著正相关性(P<0.05)。结论微透析技术是一种理想的动态监测脑损伤局部生化改变的方法;利用该技术监测损伤区ECF中糖代谢指标的异常变化,可以作为判定脑损伤程度的重要依据。Objective To explore the changes in the glucose metabolism of cerebral extracellular fluid (ECF) following traumatic brain injury (TBI) by microdialysis. Methods The ECF in the injured brain region was continuously collected by microdialysis in the rats with mild or severe traumatic brain injuries. Glucose and Lactate concentration in the dialysate (d, d ) were determined. Results The changes in d and d induced by microdialysis probe insertion were very small (P>0.05). ECF d was significantly higher after the injury than that before the injury and in the control group (P<0.05), and its change was positively related with brain injury severity and the content of brain water (P<0.05). ECF d was significanty lower after the injury than those before the injury and in the control group (P<0.05), and its change was negatively related with brain injury severity and the content of brain water (P<0.05). Conclusions Microdialysis is an ideal method for dynamically monitoring the regional ECF neurochemical substances following TBI. The changes in d and d caused by TBI are important biochemical indexes which may be used to determine the extent of TBI.

关 键 词：颅脑损伤 微透析 葡萄糖 乳酸 细胞外液 

分 类 号：R651.15[医药卫生—外科学] R589.1[医药卫生—临床医学]