Edgren E, Terent A, Hedstrand U, Ronquist G
Crit Care Med. 1983 Jan;11(1):4-6. doi: 10.1097/00003246-198301000-00002.
To investigate the possibility of improving the accuracy of prognostication in early hypoxic brain damage, 12 patients with global cerebral ischemia (GCI) due to circulatory arrest outside hospital were followed until death or for 1 yr. Five who survived for more than 2 weeks displayed better values on coma scoring from 16 h-3 days, compared to those who succumbed within 2 weeks. In 2 week-survivors, lumbar puncture revealed consistently lower adenylate kinase (AK) activity in cerebrospinal fluid (CSF) at 24 h than in the other patients, whereas glutathione and lactate values overlapped to some degree. The CSF-AK activity at 48--72 h was less correlated to clinical outcome. It is concluded that the results from coma scoring, based upon clinical observation, and from determination of AK activity in CSF at 24 h reinforce each other in discriminative power to predict prognosis in these patients.
为研究提高早期缺氧性脑损伤预后预测准确性的可能性，对12例因院外循环骤停导致全脑缺血（GCI）的患者进行随访，直至死亡或随访1年。5例存活超过2周的患者在16小时至3天的昏迷评分中显示出比在2周内死亡的患者更好的值。在存活2周的患者中，腰椎穿刺显示脑脊液（CSF）中24小时的腺苷酸激酶（AK）活性始终低于其他患者，而谷胱甘肽和乳酸值在一定程度上重叠。48 - 72小时时脑脊液AK活性与临床结果的相关性较小。结论是，基于临床观察的昏迷评分结果以及24小时时脑脊液中AK活性的测定结果在预测这些患者预后的判别能力上相互加强。
