急性颅脑损伤血清性激素水平变化与预后的研究  

Relationship between changes of serum sex hormones and prognosis in patients with acute craniocerebral injury

作　　者：王冬梅[1] 常杰[1] 白云贤[1] 王莉[1] 张艳[1] 张玉杰[1] 

机构地区：[1]宁夏银川市第一人民医院神经外科,750001

出　　处：《中华神经外科杂志》2014年第7期715-717,共3页Chinese Journal of Neurosurgery

摘　　要：目的 探讨急性颅脑损伤后,患者血清性激素动态变化对其损伤程度及预后的影响.方法 根据格拉斯哥昏迷评分（GCS）对患者损伤程度进行（轻、中、重）分型,采用格拉斯哥预后评分（GOS）对患者预后进行评定,采集急性颅脑损伤后轻型、中型、重型共153例患者伤后第1天、第7天静脉血,使用雌二醇（E2）、孕酮（P）、睾酮（T）性激素定量测定的方法,动态监测306份血清中三种性激素的含量,分析急性颅脑损伤患者血清E2、P、T动态变化与其损伤程度及预后的相关关系.结果 急性颅脑损伤轻、中、重型患者第1天血清E2、P、T含量较第7天明显升高,且GCS评分与E2、P、T含量呈负相关关系,患者血清E2、P、T含量与患者GOS评分也呈负相关,P＜0.05.结论 早期动态监测急性颅脑损伤患者血清E2、P、T含量变化,可作为尽早、快速判断患者损伤程度及预后的指标,并为必要时对急性颅脑损伤患者进行干预治疗（适当补充性激素）提供治疗依据.Objective To evaluate the effects of the dynamic changes of serum sex hormones on the injury severity and prognosis of acute craniocerebral injury.Methods The injury severity （light,medium,and heavy） was evaluated through GCS score and the prognosis was evaluated with GOS.Intravenous blood was collected respectively from 153 patients with light,medium,and heavy injury at the first day and the 7th day after acute head injury.The quantitative method was used dynamically to determine the sexual hormone contents （serum E2,P,and T） in the serum.The relationships among the dynamic changes of serum sex hormones,the severity of injury and the prognosis after acute craniocerebral injury were analyzed.Results The contents of the serum E2,P,and T at the first day after injury were increased significantly than those at the seventh day in the patients with all types of acute head injury.Meanwhile,the changes showed that the contents of the serum E2,P,and T were increased with the decrease of GCS score at both time points.There was a negative correlation between the contents of serum E2,P,and T and the GCS score and GOS score （P 〈 0.05）.Conclusions Early dynamically monitoring the changes of sexal hormone contents in serum of patients with acute traumatic craniocerebral injury could be used as the early indicators of rapid judgment of injury severity and prognosis.It could provide the basis for intervene therapy （proper application of sex hormones） in patients with acute craniocerebral injury.

关 键 词：急性颅脑损伤 性激素 损伤程度 预后 

分 类 号：R651.15[医药卫生—外科学]