Department of Anaesthesia & Pain Medicine, Royal Perth Hospital, Perth, Australia.
Antioxid Redox Signal. 2011 Nov 15;15(10):2663-7. doi: 10.1089/ars.2011.4125. Epub 2011 Jul 22.
Current diagnostic tools to assess neurological injury after aneurysmal subarachnoid hemorrhage (aSAH) and traumatic brain injury (TBI) have poor discriminatory abilities. Free radicals are associated with the pathophysiology of secondary damage after brain trauma. We examined cerebrospinal fluid (CSF) lipid markers of oxidative stress, isofurans (IsoFs), F(4)-neuroprostanes (F(4)-NeuroPs), and F(2)-isoprostanes (F(2)-IsoPs), in two case-controlled studies in patients with aSAH or severe TBI. Patients with aSAH (n=18) or TBI (n=18) were age and gender matched with separate control groups. CSF samples were collected from patients within 24 h of the injury. CSF IsoFs and F(4)-NeuroPs were increased in aSAH patients compared with their controls. In TBI patients, IsoFs and F(4)-NeuroPs were increased compared with their controls. F(2)-IsoPs were increased in aSAH patients, but not in TBI patients, compared with their respective controls. CSF IsoFs and F(4)-NeuroPs are consistently increased after a catastrophic central nervous system injury. These results suggest their measurement may enhance the management of unconscious patients in neurological care.
目前用于评估蛛网膜下腔出血（aSAH）和创伤性脑损伤（TBI）后神经损伤的诊断工具的鉴别能力较差。自由基与脑外伤后的继发性损伤的病理生理学有关。我们在两项病例对照研究中检查了蛛网膜下腔出血或严重 TBI 患者的脑脊液（CSF）氧化应激脂质标志物、异呋喃（IsoFs）、F(4)-神经前列腺素（F(4)-NeuroPs）和 F(2)-异前列腺素（F(2)-IsoPs）。aSAH 患者（n=18）或 TBI 患者（n=18）与单独的对照组进行了年龄和性别匹配。患者的 CSF 样本在受伤后 24 小时内采集。与对照组相比，aSAH 患者的 CSF IsoFs 和 F(4)-NeuroPs 增加。与对照组相比，TBI 患者的 IsoFs 和 F(4)-NeuroPs 增加。与各自的对照组相比，aSAH 患者的 CSF F(2)-IsoPs 增加，但 TBI 患者则没有。灾难性中枢神经系统损伤后，CSF IsoFs 和 F(4)-NeuroPs 持续增加。这些结果表明，它们的测量可能会增强对神经科护理中无意识患者的管理。
