Terent A, Ronquist G, Bergström K, Hällgren R, Aberg H
Stroke. 1981 Jan-Feb;12(1):33-40. doi: 10.1161/01.str.12.1.33.
Thirteen patients with stroke and one with TIA had repeated examinations with computed tomography (CT) of the head, examination of the cerebrospinal fluid (CSF) for adenylate kinase, glutathione, lactate, and albumin and clinical evaluations during the first fortnight after onset. In 9 patients with cerebral infarction edema shown on the CT scans was maximal on days 2--5, after which it diminished. In 2 patients with intracerebral hemorrhage the edema appeared early as a zone of low-attenuation around the high-attenuation area. Most patients with large lesions deteriorated clinically during development of the edema. In 3 patients the CT scans were inconclusive, probably because the lesion was too small. Adenylate kinase activity was present in all CSF samples during the period 6 hours-5 days, while glutathione was occasionally present in the CSF in 12 of the 14 patients. These findings are believed to indicate cell swelling and a leak in the plasma membrane. Based on these observations, it is suggested that initial ischemic edema is intracellular in patients with cerebral infarction, and that adenylate kinase in CSF is a sensitive marker for this type of edema.
13例中风患者和1例短暂性脑缺血发作（TIA）患者在发病后的头两周内接受了多次头部计算机断层扫描（CT）、脑脊液（CSF）中腺苷酸激酶、谷胱甘肽、乳酸和白蛋白的检测以及临床评估。在9例CT扫描显示有脑梗死水肿的患者中，水肿在第2至5天达到最大，之后逐渐减轻。在2例脑出血患者中，水肿早期表现为高衰减区域周围的低衰减带。大多数有大面积病变的患者在水肿发展过程中临床症状恶化。3例患者的CT扫描结果不明确，可能是因为病变太小。在6小时至5天期间，所有脑脊液样本中均存在腺苷酸激酶活性，而14例患者中有12例脑脊液中偶尔存在谷胱甘肽。这些发现被认为表明细胞肿胀和质膜渗漏。基于这些观察结果，提示脑梗死患者最初的缺血性水肿是细胞内的，脑脊液中的腺苷酸激酶是这种类型水肿的敏感标志物。
