颅脑外伤患者围术期抗氧化能力及氧代谢状态的变化探讨  

Exploration of perioperative antioxidant capacity and oxygen metabolic state in traumatic brain injury patients

作　　者：魏健强[1] 薛婷婷[1] 李建[1] 马剑[1] 

机构地区：[1]延安大学附属医院东关分院神经外科四病区,延安716000

出　　处：《中国实用神经疾病杂志》2016年第17期5-7,共3页Chinese Journal of Practical Nervous Diseases

基　　金：国家自然基金;编号H0906

摘　　要：目的 探讨颅脑外伤患者围术期的抗氧化能力及氧代谢状态的变化,为临床研究提供参考依据。方法 选择2013-05—2014-06收治的150例颅脑外伤患者,同期选择150例健康志愿者为对照组,采用比色法检测2组患者SOD、GSHPX、CSH、VitE、MDA以及总抗氧化能力等抗氧化能力指标水平,同时动态检测颅脑损伤患者在围手术期血液抗氧化能力指标水平的变化。通过颈内静脉血气和桡动脉血气检测2组患者SjvO2、CEO2及AVDO2等脑氧代谢指标的水平,同时动态检测颅脑外伤患者在围手术期脑氧代谢指标水平的变化。结果 经过检测,颅脑外伤患者血液中抗氧化指标SOD、MDA及总抗氧化能力的水平较对照组显著提高,GSH-PX、CSH、VitE的水平较对照组显著降低,2组比较各项指标差异具有统计学意义（P〈0.05）。GCS 68分与GCS 35分的颅脑外伤患者与对照组比较抗氧化指标的水平差异更为明显;颅脑外伤组患者的血液中SOD、总抗氧化能力、GSH-PX、CSH及VitE等抗氧化指标的水平在围手术期均降低,MDA水平在围手术期逐渐升高;颅脑外伤组患者的SjvO2、CEO2及AVDO2等脑氧代谢指标均较对照组的水平显著降低,差异具有统计学意义（P〈0.05）。且SjvO2与CEO2的水平与GCS评分成正比例关系;颅脑外伤组患者的SjvO2、CEO2及AVDO2等脑氧代谢指标的水平在围手术期存在显著变化,SjvO2的水平显著升高,CEO2与AVDO2的水平显著降低。结论 颅脑外伤患者的抗氧化能力指标以及脑氧代谢指标较正常人水平发生显著变化,需引起临床医生的重视。Objective To investigate the changes of perioperative antioxidant capacity and oxygen metabolic state in traumatic brain injury patients, in order to provide references for clinical research. Methods Totally 150 cases of traumatic brain injury from May 2013 to June 2014 were admitted as study group and 150 healthy volunteers during the same period were selected as control group. By using colorimetric assay,we detected not only the levels of SOD,GSH-PX,CSH,VitE, MDA and total antioxidant capacity and so on, but the dynamic changes of perioperative blood indices referring to antioxidant capacity as well. In addition, oxygen metabolic markers including the levels of SjvO2 ,CEO2 and AVDO2 as well as their dynamic changes at the perioperative period were tested through the examination of blood-gas analysis. Results Compared with the control group, the study group showed higher levels of blood SOD, MDA and total antioxidant capacity and reflected lower levels of GSH-PX, CSH and VitE,and all differences were significant （P〈0.05）,which were more obvious when compared patients with GCS scores of 6-8 points or 3-5 points with controls. The levels of SOD, total antioxidant capacity, GSH-PX, CSH and antioxidant indicators such as VitE in the study group were decreased at the perioperative period. The levels of SjvO2 ,CEO2, AVDO2 and other brain oxygen metabolism parameters in the study group were significantly lower than those in the control group, with sig- nificant differences （P 〈0.05）. And the levels of SjvO2 and CEO2 had positive relations with GCS scores. Conclusion Antioxidative capacity indices and cerebral oxygen metabolic indicators in patients with traumatic brain injury have more tremendous changes than those in healthy controls, which should be paid close attention to.

关 键 词：颅脑外伤 围术期 抗氧化能力 氧代谢 

分 类 号：R651.15[医药卫生—外科学]