严重脑外伤急性期血浆儿茶酚胺含量变化及其临床意义  

^^Change of serum catecholamine and its clinical signifi-cance in patients with severe head injury

作　　者：张赛[1,2,3] 杨树源[1,2,3] 王明璐[1,2,3] 张瑞珠[1,2,3] 张卫华[1,2,3] 白云[1,2,3] 

机构地区：[1]天津医科大学总医院神经外科 [2]天津市神经病学研究所生化室 [3]天津市脑系科医院神经外科

出　　处：《中国危重病急救医学》1995年第3期150-153,共4页Chinese Critical Care Medicine

摘　　要：报告４８例成人严重脑外伤后７天内血浆儿茶酚胺（ＣＡ）测定结果。发现伤后７天内血ＣＡ明显高于正常对照组：血去甲肾上腺素（ＮＥ）、肾上腺素（Ｅ）分别与格拉斯哥昏迷分级（ＧＣＳ）呈显著负相关（ｒ＝－０．７４４，Ｐ＜０．００１和ｒ＝－０．６３６，Ｐ＜０．００１）。血ＮＥ、Ｅ与患者的预后也密切相关。死亡组血ＮＥ、Ｅ均明显高于存活组。伤后２４ｈ内血ＮＥ超过１２００ｎｇ／Ｌ者，８８％于伤后１个月内死亡，血Ｅ超过６５０ｎｇ／Ｌ者，７５％死亡。死亡组伤后７天内血ＮＥ、Ｅ持续在较高水平。由此可见，测定伤后急性期血ＮＥ、Ｅ对判断病情和评估预后均有临床意义。作者结合文献讨论了治疗问题。The serum levels of catecholamines (CA)includingnorepinephrine(NE ), epinephrine ( E ), and dopamine(DA ) were measured in 48 adult patients with severehead injury in the first 7 days after injury and in 35 nor-mal adults as the controls. The results showed that theserum CA level was significantly higher in the injurygroup than in the controls. The lower the GCS scorewas, the higher the serum NE and E levels. The serumNE and E levels were higher in the dead group than inthe survival group. 88% of the patients with NE levelsover 1200pg/ml within the 24 hours after injury diedduring the first month;the mortality was 75%in the pa-tients with E level over 650pg/ml. These data suggestthat in the acute stage of severe head injury the elevationof the serum CA level is a significant indicator of theseverity and a significant predicator of the outcome ofthe disease.

关 键 词：颅脑损伤 儿茶酚胺 预后 

分 类 号：R651.150.2[医药卫生—外科学]