脑损伤后基于脑电图分级的脑功能与脑内神经递质的关系  

The association of neurotransmitter and brain function evaluated by EEG after brain injury

作　　者：何任红[1] 范建中[1] 邱玲[1] 郑碧娥 张吉敏 HE Renhong;FAN Jianzhong;QIU Ling;ZHENG Bi’e;ZHANG Jimin(Department of Rehabilitation Medicine,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院康复医学科,广东广州510515

出　　处：《中国实用神经疾病杂志》2019年第17期1857-1863,共7页Chinese Journal of Practical Nervous Diseases

基　　金：广东省援疆科技项目专项基金(编号:2017B020247001)。

摘　　要：目的探讨脑损伤后患者基于脑电图分级的脑功能与脑内神经递质的关系,以期了解神经递质在脑功能恢复中的作用。方法回顾分析南方医科大学南方医院治疗的脑损伤患者,按照改良的脑电图分级方法,其中把Ⅰ级和Ⅱ级定义为脑功能良好,Ⅲ级及以上定义为脑功能较差,共收集39例,其中良好组23例,较差组16例,2组患者入组后先采集基本资料,然后收集脑电图评估时的脑内神经递质情况(使用脑涨落图的方法检测),检测指标包括γ-氨基丁酸(γ-GABA)、5-羟色胺(5-HT)、去甲肾上腺素、多巴胺等递质的递质功率、递质相对功率和指数分析,指数分析指标包含总功率、运动指数、兴奋抑制指数和血管舒缩指数,先比较2组间递质的差异性,然后使用二分类Logistic回归进行分析。结果较差组脑内递质功率均显著低于良好组;2组间递质相对功率差异无统计学意义(P>0.05);2组间指数分析,除总功率组间存在显著差异外,其他指数间差异无统计学意义(P>0.05);Logistic回归分析显示γ-GABA和5-HT是可以显著影响结局的因素。结论脑损伤后患者脑内大部分神经递质会减少,其中γ-GABA和5-HT可影响脑功能恢复程度,在脑损伤的临床康复治疗中,可以考虑使用能改善γ-GABA和5-HT递质效能的治疗方法。Objective To explore the association of neurotransmitter and brain function evaluated by EEG after brain injury and know the role of neurotransmitter in brain function.Methods The patients with brain injury were analyzed retrospectively and divided into good group(23 cases,level 1&2 in EEG)and bad group(16cases,level 3 and up in EEG).Basic data was collected and neurotransmitter was obtained from encephalofluograph.The neurotransmitter containsγ-GABA,5-HT,NE and DA and so on.Power,relative power and index analysis of these neurotransmitter were calculated to be the outcome of this study.The difference between groups was analyzed and Logistic regression analysis was made to classify the relationship between these neurotransmitter and recovery outcome.Results The power of all neurotransmitter at bad group was significantly lower than it at good group.Relative power between groups was no obvious difference.The index analysis was also no obvious difference,except total power.Logistic regression analysis showed that the deficiency ofγ-GABA and 5-HT are significant impaired factors.Conclusion Most of neurotransmitter in good patients after brain injury is remarkably decreased.In particularly,the deficiency ofγ-GABA and 5-HT seem to impair the recovery of brain injury.Drugs or rehabilitation therapy which can improveγ-GABA and 5-HT potential can be considered to improve brain function after brain injury.

关 键 词：脑损伤 昏迷 脑涨落图 神经递质 Γ-氨基丁酸 5-羟色胺 

分 类 号：R651.15[医药卫生—外科学]