Zhou D, Qiu M, Guan Y, Li L
Department of Neurosurgery, Tongji Hospital, Tongji Medical University, Wuhan 430030.
J Tongji Med Univ. 2000;20(2):148-50. doi: 10.1007/BF02887058.
To investigate the content and dynamics of nitric oxide (NO) in the cerebrospinal fluid (CSF) of patients with acute head injury and to clarify the relationship of NO with clinical features and intracranial pressure (ICP) as well as outcomes, 38 adults with acute head injury were studied. Glasgow Coma Scale (GCS) obtained at admission and Glasgow Outcome Scale (GOS) 3 months after injury was assessed. ICP was surveyed via intraventricular catheter and lumbar puncture and CSF samples were obtained simultaneously. NO was determined with Griess reagents. Results showed that NO peak content in the head injury group was significantly higher than that of the control group. During dynamic research, no peak content of mildly injured cases and severely injured ones appeared in different time windows respectively. The peak value of NO was distinctly higher in the severe group than in the mild group. NO peak value of the raised ICP group was remarkably higher than that of the normal ICP group. The peak value of NO was considerately higher in the poor outcome group than in the good outcome group. When the content of NO was over 6.5 mumol/L, the rate of poor outcome was increased. There existed a correlation between NO and GCS, ICP and GOS. It is concluded that the content of NO was increased in patients with acute head injury and the changes of NO had different time windows in severely injured patients and mildly injured ones. The more sever the injury, the higher the NO content; and the more serious the secondary brain injury and brain edema, the worse the outcomes. When NO is combined with GCS, GOS and ICP, it increases the accuracy of judgement to the degree of head injury and outcome.
为研究急性颅脑损伤患者脑脊液（CSF）中一氧化氮（NO）的含量及动态变化，阐明NO与临床特征、颅内压（ICP）及预后的关系，对38例急性颅脑损伤成人患者进行了研究。评估入院时的格拉斯哥昏迷量表（GCS）及伤后3个月的格拉斯哥预后量表（GOS）。通过脑室内导管和腰椎穿刺测量ICP，并同时采集CSF样本。用格里斯试剂测定NO。结果显示，颅脑损伤组NO峰值含量显著高于对照组。在动态研究中，轻度损伤病例和重度损伤病例在不同时间窗均未出现峰值含量。重度组NO峰值明显高于轻度组。ICP升高组NO峰值明显高于正常ICP组。预后不良组NO峰值明显高于预后良好组。当NO含量超过6.5μmol/L时，预后不良率增加。NO与GCS、ICP和GOS之间存在相关性。结论：急性颅脑损伤患者NO含量升高，重度损伤患者和轻度损伤患者NO变化有不同时间窗。损伤越严重，NO含量越高；继发性脑损伤和脑水肿越严重，预后越差。当NO与GCS、GOS和ICP结合时，可提高对颅脑损伤程度和预后判断的准确性。
