McArthur J, Hill J, Paech M J, Dodd P H, Bennett E-J, Holden J
Department of Anaesthesia and Pain Medicine, King Edward Memorial Hospital for Women, 374 Bagot Road, Subiaco, WA 6008, Australia.
Anaesthesia. 2005 Feb;60(2):163-7. doi: 10.1111/j.1365-2044.2004.04067.x.
We conducted a prospective observational study among a cohort of 40 term parturients undergoing spinal anaesthesia for elective Caesarean section, to determine the concentration of beta-trace protein in cerebrospinal fluid (CSF) and serum. Serum and CSF samples, taken at the time of dural puncture, were assayed by nephelometry. The mean serum beta-trace protein concentration was 0.39 mg.l(-1) and the mean CSF concentration was 27.9 mg.l(-1), giving a mean ratio of CSF to serum concentration of 76. This ratio is higher than that published for non-pregnant females and for males because of both a higher mean CSF and a lower mean serum beta-trace protein concentration. The concentration correlated positively with both serum creatinine and gestational age. If these concentrations are used to estimate the normal range, we propose that the nephelometric measurement of beta-trace protein might prove a useful diagnostic test for cerebrospinal fluid-cutaneous fistula in parturients.
我们对40名择期剖宫产接受脊髓麻醉的足月产妇进行了一项前瞻性观察研究,以测定脑脊液(CSF)和血清中β-微球蛋白的浓度。在硬膜穿刺时采集的血清和脑脊液样本,采用散射比浊法进行检测。血清β-微球蛋白的平均浓度为0.39mg·l⁻¹,脑脊液的平均浓度为27.9mg·l⁻¹,脑脊液与血清浓度的平均比值为76。由于脑脊液中β-微球蛋白的平均浓度较高,血清中β-微球蛋白的平均浓度较低,该比值高于非妊娠女性和男性的报道值。该浓度与血清肌酐和孕周均呈正相关。如果用这些浓度来估计正常范围,我们认为β-微球蛋白的散射比浊法检测可能是诊断产妇脑脊液-皮肤瘘的一项有用的诊断试验。