Nayak Chandrika, Nayak Dinesh, Raja Annaswamy, Rao Anjali
Department of Biochemistry, Melaka Manipal Medical College, International Centre for Health Sciences, Manipal 576104, Karnataka, India.
Neurol Res. 2008 Jun;30(5):461-4. doi: 10.1179/016164107X251790.
Epidemiologic works reveal that moderate head injury (MHI) is more frequent and a substantial number of these patients develop complications resulting in neurological disabilities. Reactive oxygen species (ROS) play a major role in post-traumatic neuronal damage following traumatic head injury. Thus, the current study analysed the post-traumatic changes in the erythrocyte markers of oxidative damage and the relationship between these parameters and Glasgow coma scale (GCS) scores of MHI patients during the 7 day study period.
Peripheral venous blood samples were taken at the time of hospital admission (d1 of injury) and on d7 from 25 MHI patients (admission GCS score > 8). These were compared with samples from 25 healthy individuals (normal controls, NC). GCS scores were recorded at the same time points of the study period. Erythrocyte lipid peroxidation (LP) and thiol oxidation levels were estimated and compared with that of NC. The relationship between GCS scores and erythrocyte markers were also studied.
Erythrocyte thiobarbituric acid reactive substance (TBARS) levels reflecting lipid peroxidative damage remained significantly elevated at both time points of the study period in MHI patients as compared to NC (p < 0.001 ). There was a significant decrease in the level of nonprotein thiols in MHI patients as compared to NC (p < 0.01) at the same time points of the study. However, on d7 there were no further significant changes in the markers of oxidative damage in MHI patients as compared to on d1.
These findings suggest that a condition of oxidative stress occurs during the entire post-traumatic period in MHI patients and the utility of markers of oxidative damage in the prognosis of head injury needs to be addressed in further works.
流行病学研究表明，中度颅脑损伤（MHI）更为常见，且相当一部分此类患者会出现并发症，导致神经功能障碍。活性氧（ROS）在创伤性脑损伤后的创伤后神经元损伤中起主要作用。因此，本研究分析了氧化损伤的红细胞标志物在创伤后的变化，以及在为期7天的研究期间这些参数与MHI患者格拉斯哥昏迷量表（GCS）评分之间的关系。
采集25例MHI患者（入院时GCS评分>8）入院时（受伤第1天）和第7天的外周静脉血样本。将这些样本与25名健康个体（正常对照组，NC）的样本进行比较。在研究期间的相同时间点记录GCS评分。估计红细胞脂质过氧化（LP）和硫醇氧化水平，并与NC组进行比较。还研究了GCS评分与红细胞标志物之间的关系。
与NC组相比，反映脂质过氧化损伤的红细胞硫代巴比妥酸反应物质（TBARS）水平在研究期间的两个时间点均显著升高（p<0.001）。在研究的相同时间点，与NC组相比，MHI患者的非蛋白硫醇水平显著降低（p<0.01）。然而，与第1天相比，MHI患者在第7天氧化损伤标志物没有进一步的显著变化。
这些发现表明，MHI患者在整个创伤后时期都存在氧化应激状态，氧化损伤标志物在颅脑损伤预后中的作用需要在进一步的研究中加以探讨。
