颅脑术后病人脑脊液乳酸脱氢酶(LDH)的改变及对脑组织损伤的评估价值  

Changes of cerebrospinal fluid lactate dehydrogenase(LDH)in patients after craniocerebral surgery and its value in evaluating brain tissue injury

作　　者：卓李圆 Zhuo Liyuan(Longgang Central Hospital,Shenzhen,Guangdong 518116,China)

机构地区：[1]广东省深圳市龙岗中心医院,广东深圳518116

出　　处：《首都食品与医药》2022年第21期48-50,共3页Capital Food Medicine

基　　金：广东省深圳市龙岗区科技创新局非扶持项目(项目编号:LGKCYLWS2020129)。

摘　　要：目的 探究颅脑术后患者脑脊液乳酸脱氢酶(LDH)水平变化及对脑组织损伤的判定价值.方法 遴选2020年1月-2021年6月期间220例颅脑损伤患者,根据损伤严重程度将研究对象分为两组,轻症组和重症组(每组110例),另择取同时期非创伤性颅脑损伤患者100例作为对照组;测定并比较三组患者于术后当日、术后24h、48h、72h不同时段血清及脑脊液LDH水平;三组脑组织损伤程度[血清神经元特异性烯醇化酶(NSE)、视神经鞘直径、颅内压(CIP)、格拉斯哥昏迷评分(GCS)],评估脑脊液LDH水平变化与脑组织损伤的相关性.结果 轻症组与重症组术后当日、术后24h、48h、72h的脑脊液LDH水平均较同时刻的对照组高(P<0.05),且重症组上述时段脑脊液LDH水平显著高于轻症组(P<0.05).轻症组与重症组术后当日、术后24h、48h、72h的血清LDH水平均较同时刻的对照组高(P<0.05),但轻症组与重症组组间比较无统计学意义(P>0.05).重症组患者血清NSE水平、神经鞘直径、颅内压较轻症组显著高,GCS评分明显低于轻症组(P<0.05).脑脊液LDH水平与血清NSE水平、神经鞘直径、颅内压均呈正相关,与GCS评分呈负相关.结论 脑脊液LDH水平变化可作为颅脑术后患者早期判定脑组织继发性损伤的重要依据,对颅脑术后患者预后评估起到显著作用.Ob ject ive To explore the changes of cerehrospinal fluid lactate dehydrogenase(LDH)level in patients after craniocerebral surgery and its value in judging brain tissue injury.Methods 220 patients with craniocerebral injury from January 2020 to June 2021 were selected.According to the severity of injury,the suhjects were divided into two groups,mild group and severe group(110 cases in each group) In addition,100 patients with non traumatic brain injury in the same period were recorded in the control group;the LDH levels of serum and cerebrospinal fluid in the three groups were measured and compared on the day afer operation,24h,48h and 72h after operation;the degree of brain tissue injury in the three groups [serum neuron specific enolase(NSE).optic nerve sheath diameter,intracranial pressure(CIP)and Glasgow Coma Score(GCS)]Results The level of cerebrospinal fluid LDH in mild group and severe group was significantly higher than that in the control group al the same time(P<0.05),and the level of cerebrospinal fluid LDH in severe group was significantly higher than that in mild group(P<O.05).The level of serum LDH in mild and severe group was significantly higher than that in control group at the same time(P<0.05),but there was no significant difference between mild and severe group(P>0.05).The level of serum NSE,nerve sheath diameter and intracranial pressure in severe group were significantly higher than those in mild group,and the GCS score was significantly lower than that in mild group(P<0.05).Conclus ion The change of cerebrospinal fluid LDH level can be used as an important basis for early determination of secondary brain injury and plays a significant role in the evaluation of prognosis of patients afier craniocerebral surgery.

关 键 词：颅脑术后 脑脊液 乳酸脱氢酶 脑组织损伤 

分 类 号：R651.15[医药卫生—外科学]