Rehabilitation Center, Niigata University Medical and Dental Hospital, Niigata-shi, Niigata, Japan.
Spine (Phila Pa 1976). 2009 Aug 15;34(18):E645-52. doi: 10.1097/BRS.0b013e3181abda1d.
Multiple center study to evaluate cerebrospinal fluid (CSF) concentrations of nitric oxide metabolites [NOx] in relation to neurologic severity and prognosis in spinal cord injury (SCI).
To examine whether CSF [NOx] correlates with neurologic severity and recovery in SCI.
Inducible nitric oxide synthase is expressed in rat spinal cord immediately after SCI. Excessive nitric oxide production is cytotoxic, causing neuronal apoptosis with subsequent neurodysfunction in the spinal cord. We previously reported a significant correlation between initial [NOx] after incomplete cervical cord injury (CCI) and neurologic recovery at the final follow-up in 25 cases.
Ninety-six cases (SCI group), including 76 patients with CCI and 20 patients with thoracic cord injury were examined. Mean follow-up period was 11 months. The control group comprised 40 cases (3 healthy volunteers and 37 patients with neither pain nor neurologic disorders). CSF [NOx] were measured using the Griess method. Severity of neurologic impairment was assessed using Frankel's classification and the American Spinal Injury Association motor score (ASIA MS). Degree of neurologic recovery was assessed using Frankel's classification and the ASIA motor recovery percentage.
CSF [NOx] did not differ significantly among the control, CCI, and thoracic cord injury groups at the initial examination. In the CCI group, [NOx] in the Frankel A and B classes were significantly higher than [NOx] in the control group at 5 to 14 days, in the Frankel A and B classes at 0 to 4 days, and in the Frankel C and D classes at 5 to 14 days. Also, in the CCI group at 5 to 14 days, [NOx] correlated significantly with ASIA MS and motor recovery percentage.
There was a significant correlation between CSF [NOx] at the pathologic early subacute stage (approximately 5-14 days) and neurologic severity and recovery in SCI.
多中心研究评估与脊髓损伤（SCI）神经严重程度和预后相关的脑脊液（CSF）中一氧化氮代谢产物[NOx]的浓度。
检测 CSF [NOx]是否与 SCI 中的神经严重程度和恢复有关。
诱导型一氧化氮合酶在 SCI 后立即在大鼠脊髓中表达。过量的一氧化氮生成具有细胞毒性，导致脊髓中的神经元凋亡和随后的神经功能障碍。我们之前在 25 例不完全颈髓损伤（CCI）后，报告了初始[NOx]与最终随访时的神经恢复之间存在显著相关性。
检查了 96 例病例（SCI 组），包括 76 例 CCI 患者和 20 例胸段脊髓损伤患者。平均随访时间为 11 个月。对照组包括 40 例（3 名健康志愿者和 37 名无疼痛和神经疾病的患者）。使用格里塞斯法测量 CSF [NOx]。使用 Frankel 分类和美国脊髓损伤协会运动评分（ASIA MS）评估神经损伤严重程度。使用 Frankel 分类和 ASIA 运动恢复百分比评估神经恢复程度。
在初始检查时，对照组、CCI 组和胸段脊髓损伤组的 CSF [NOx] 无显著差异。在 CCI 组中，Frankel A 和 B 级的[NOx]在 5 至 14 天、Frankel A 和 B 级在 0 至 4 天、Frankel C 和 D 级在 5 至 14 天内显著高于对照组。此外，在 CCI 组的 5 至 14 天内，[NOx]与 ASIA MS 和运动恢复百分比显著相关。
在病理早亚急性阶段（约 5-14 天），CSF [NOx]与 SCI 中的神经严重程度和恢复之间存在显著相关性。
