摘要
目的 研究急性脑外伤后垂体 -甲状腺轴和性腺轴激素改变 ,以及脑脊液中环磷酸腺苷 (c AMP)和环磷酸鸟苷 (c GMP)含量的变化 ,探讨其临床意义。方法 采用放射免疫分析法前瞻性的研究 ,分别于伤后或术后 1～ 2天、5～ 7天、12～ 14天、2 0～ 2 2天检测了 18例急性脑外伤患者血中垂体、甲状腺和性腺激素以及脑脊液中 c AMP和 c GMP含量 ,与对照组 10例进行比较。结果 c AMP、c GMP伤后早期较对照组明显降低 (P<0 .0 1) ,中晚期逐步升高并接近对照组。血清三碘甲状腺原氨酸 (T3)、甲状腺素 (T4)伤后早期较对照组明显降低 (P<0 .0 5 ,P<0 .0 1) ,随意识好转 T3接近正常 ,T4浓度增高 ,但未恢复正常。卵泡刺激素早期无明显改变 ,中期明显降低 (P<0 .0 1) ,晚期接近正常 ;睾酮观察期间均较对照组降低(P<0 .0 1) ,虽晚期有所升高 ,但未恢复正常。皮质醇伤后早期升高 ,但与对照组无明显差别 (P>0 .0 5 )。c AMP、血清 T4与GCS评分减少有相关关系 ,GCS评分愈低 ,c AMP和 T4降低就愈明显 (P<0 .0 5 ) ,随意识障碍改善而逐渐升高。结论 急性脑外伤可影响脑脊液 (CSF)中 c AMP和 c GMP,及下丘脑垂体 -甲状腺和性腺轴的功能 ,其变化程度与脑伤程度有关 。
Objective To elucidate the clinical significance of pituitary endocrine changes,and the levels of cyclic adenosine monophosphate(cAMP)and cyclic guanosine monophosphate(cGMP) in the cerebrospinal fluid(CSF) of patients with brain injury.Methods The hormones of pituitary,thyroid and gonad of eighteen patients with acute brain injury were determined by radioimmunoassay on days 1～2,days 5～7,days 12～14 and days 20～22 after trauma or operation,respectively.Results The average levels of CSF cAMP and cGMP decreased significantly in the early period after brain injuries as compared with those of control group,and then they increased gradually in the middle and late periods.The average levels of serum T 3and T 4decreased significantly in the early period after trauma( P<0.05,P <0.01)as compared with those of control group,and later on ,with the improvement in the patientsconsciousness,the average level of serum T 3approached normal,and the level of T 4increased but not to normal.The average level of serum FSH did not undergo obvious changes in the early period;it decreased significantly in the middle period( P <0.01) and approached normal in the late period.The average level of serum testosterone decreased significantly( P <0.01),and it increased but not to normal in the late period. Conclusion These findings indicate there is a positive correlation of the average levels of CSF cAMP,cGMP and pituitary endocrine function with the severity of acute brain injuries,thus suggesting that the dynamical measurement of CSF cAMP,cGMP and pituitary and target organism hormones are useful for evaluating the severity and prognosis of the patients with acute brain injuries.
出处
《四川医学》
CAS
2001年第7期607-609,共3页
Sichuan Medical Journal
关键词
急性脑外伤
垂体内分泌
激素
环磷酸原昔
环磷酸鸟昔
Brain injuries Hormones Hypopituitarism Cyclic adenosine monophosphate Cyclic guanosine monophosphate
