脑脊液中可溶性ICAM-1含量变化与创伤性颅脑损伤程度的关系  

Relationship between the level of soluble ICAM-1 in CSF and the extent of cerebral damagein the patients with severe traumatic brain injury

作　　者：苏亦兵[1] 赵继宗[2] 富壮[1] 

机构地区：[1]北京积水潭医院神经外科,100035 [2]首都医科大学附属北京天坛医院

出　　处：《北京医学》2003年第5期298-300,共3页Beijing Medical Journal

摘　　要：目的　探讨可溶性ICAM 1在脑脊液 (CSF)和血清中含量的变化情况与脑损伤程度的关系及其对脑损伤的作用机制。方法　 30例患者分二组 ,A组 18例 ,为重型颅脑损伤 ,GCS≤ 8分 ;B组 12例 ,为轻型颅脑损伤 ,GCS =15分。脑损伤程度通过CT及BBB损伤程度来评估。血脑屏障破坏程度通过计算QA值即CSF/血清蛋白比率评估。用sICAM 1试剂盒 ,采用酶联免疫吸附实验 (ELISA)分析CSF及血清中可溶性ICAM 1的含量。结果　A组患者CSF可溶性ICAM 1水平为 4 .13～ 14 .11ng/ml,明显高于正常值。B组患者CSF中可溶性ICAM 1水平为 2 .36～ 3.10ng/ml,无升高或仅轻微升高。CSF中可溶性ICAM 1水平与血脑屏障损伤程度相关 (QA指数 ) (r=0 .95 9,P <0 .0 0 1)。结论　CSF中可溶性ICAM 1水平的升高可能提示正在进行的免疫激活反应 ,并且可溶性ICAMObjective To investigate the correlation between the changes of ICAM 1 levels in CSF and serum and the extent of cerebral damage,furthermore,to elucidate the mechanism of structural brain injury.Methods 30 patients were devided into two groups.Group A patients had severe brain injury,GCS≤8.Group B had mild brain injury,GCS=15.The extent of brain was estimated by CT as well as the extent of BBB dysfunction was calculated by CSF/serum albumin ration (QA) in the patients with severe traumatic brain injury (TBI).Results Patients of Group A had ICAM 1 levels in CSF above normal range,presented marked cerebral damage and a disturbance of BBB (range 4.13～14.11ng/ml,n=8).In contrast,patiens of Group B had no elevation of ICAM 1 level in CSF (range 2.36～3.10ng/ml,n=12; P < 0.001 ) and showed minor cereral damage with an intact BBB in most cases.In addition overall analysis showed that ICAM 1 levels in CSF correlated with the extent of BBB damage as indicated by QA ( r=0.959,P< 0.001 ).Conclusions It is suggested that increased soluble ICAM 1 level in CSF might depict ongoing immunologic activation and ICAM 1 might correlate with the extent of tissue and BBB damage.

关 键 词：脑脊液中可溶性ICAM-1 含量 创伤性颅脑损伤 作用机制 评估 酶联免疫吸附实验 

分 类 号：R651.15[医药卫生—外科学]