Tisell M, Tullberg M, Månsson J-E, Fredman P, Blennow K, Wikkelsø C
Institute of Clinical Neuroscience, Sahlgrenska University Hospital, Göteborg University, Göteborg, Sweden.
Eur J Neurol. 2004 Jan;11(1):17-23. doi: 10.1046/j.1351-5101.2003.00698.x.
To compare levels of biochemical markers in ventricular cerebrospinal fluid (vCSF) between patients with aqueductal stenosis (AS) and idiopathic normal pressure hydrocephalus (INPH) and relate these results to clinical outcome after surgery. Neurofilament light protein, tau protein, sulfatide, vasoactive intestinal peptide (VIP), neuropeptide PYY (NPY) and CSF/serum albumin ratio were measured in vCSF from 18 consecutive AS and 19 consecutive INPH patients. Clinical outcome was evaluated after surgery by standardized indices. The levels of markers were related to clinical outcome. No differences in any of the markers were found between AS and INPH patients. The concentration of sulfatide and albumin ratio correlated inversely with psychometric improvement, whilst VIP and NPY correlated inversely with improvement in alertness. The similar levels of biochemical markers in vCSF from AS and INPH patients indicate similarities in pathophysiology and turnover rate of vCSF despite differences in CSF dynamics. High albumin ratio and sulfatide concentrations in vCSF in hydrocephalus patients have negative implications for surgical outcome and might indicate concomitant cerebrovascular disorder.
比较导水管狭窄（AS）患者与特发性正常压力脑积水（INPH）患者脑室脑脊液（vCSF）中生化标志物的水平，并将这些结果与手术后的临床结局相关联。对18例连续的AS患者和19例连续的INPH患者的vCSF进行神经丝轻链蛋白、tau蛋白、硫脂、血管活性肠肽（VIP）、神经肽PYY（NPY）及脑脊液/血清白蛋白比值的检测。术后通过标准化指标评估临床结局。将标志物水平与临床结局相关联。AS患者和INPH患者之间未发现任何标志物存在差异。硫脂浓度和白蛋白比值与心理测量改善呈负相关，而VIP和NPY与警觉性改善呈负相关。AS患者和INPH患者vCSF中生化标志物水平相似，这表明尽管脑脊液动力学存在差异，但vCSF的病理生理学和周转率具有相似性。脑积水患者vCSF中高白蛋白比值和硫脂浓度对手术结局具有负面影响，可能提示合并脑血管疾病。
