Departments of Intensive Care Unit, Xuzhou Children's Hospital, Xuzhou, Jiangsu Province, China.
Eur Rev Med Pharmacol Sci. 2017 Sep;21(18):4153-4160.
The present study was planned to explore the role of 8-isomeric-prostaglandinF2α (8-iso-PGF2α) levels at the multiple sites of cerebrospinal fluid in children with intracranial hemorrhage.
90 children with intracranial hemorrhage were admitted to Surgery Intensive Care Unit (SICU) of our hospital from January to December 2013 and were selected as study subjects. They were divided into group A (n=30), group B (n=30) and group C (n=30). The group A was given conventional treatment, the group B was treated with minimally invasive puncture and the group C was treated with cerebrospinal fluid decompression. After 1 d, 2 d, 3 d, and 7 d of hospitalization, enzyme-linked immunosorbent assay (ELISA) was used to detect the 8-iso-PGF2α levels in peripheral blood of children in all groups. On the day of admission and 10 d after treatment, 3 groups of children were implemented with brain nuclear magnetic resonance spectroscopy for metabolite analyses.
On the day of admission there were no significant differences in the 8-iso-PGF2α levels among group A, B and C. Further, after 1 d, 3 d, 7 d of hospital stay, the 8-iso-PGF2α levels in peripheral blood showed a gradual downward trend, and decline range of the group C was greater than that of group A and B (p < 0.05). After 10 days of treatment, there were significant differences in the bilateral temporal lobe and hippocampal NAA/Creatinine (Cr), Cho/Cr, mI/Cr and NAA/mI among group A, B, and C. The survival rate of group C was higher than that of group A and B (p < 0.05). On the other hand, the prevalence of sequelae was significantly lower than that of group A and B (p < 0.05). The amount of blood loss in children with intracranial hemorrhage was positively correlated with the levels of 8-iso-PGF2α in peripheral blood (r = 0.546, p < 0.05) as observed by Spearman correlation analysis.
8-iso-PGF2α plays an important role in the pathogenesis of intracranial hemorrhage, and could be utilized as a biomarker of oxidative stress in children with intracranial hemorrhage. Further, cerebrospinal fluid decompression is a better method of treatment for intracranial hemorrhage.
本研究旨在探讨 8-异前列腺素 F2α（8-iso-PGF2α）在儿童颅内出血脑脊液多个部位的水平的作用。
选择 2013 年 1 月至 12 月我院外科重症监护病房（SICU）收治的 90 例颅内出血患儿为研究对象，将其分为 A 组（n=30）、B 组（n=30）和 C 组（n=30）。A 组给予常规治疗，B 组给予微创穿刺治疗，C 组给予脑脊液减压治疗。住院后第 1、2、3、7 天，采用酶联免疫吸附法（ELISA）检测各组患儿外周血 8-iso-PGF2α 水平。入院当天和治疗后第 10 天，三组患儿均进行脑磁共振波谱代谢分析。
入院时，A、B、C 三组患儿 8-iso-PGF2α 水平无显著差异。进一步，住院后第 1、3、7 天，外周血 8-iso-PGF2α 水平呈逐渐下降趋势，C 组下降幅度大于 A、B 组（p<0.05）。治疗后第 10 天，A、B、C 三组患儿双侧颞叶及海马区 NAA/Cr、Cho/Cr、mI/Cr 和 NAA/mI 差异有统计学意义。C 组患儿的存活率高于 A、B 组（p<0.05）。另一方面，C 组患儿的后遗症发生率明显低于 A、B 组（p<0.05）。颅内出血患儿出血量与外周血 8-iso-PGF2α 水平呈正相关（r=0.546，p<0.05）。
8-iso-PGF2α 在颅内出血的发病机制中起重要作用，可作为儿童颅内出血氧化应激的生物标志物。进一步，脑脊液减压是治疗颅内出血的较好方法。
