【摘要】 目的　观察创伤性脑损伤患者不同伤情、不同时期血清中可溶性 Fas(Soluble Fas,s Fas)、Fas配体(Fas ligand,Fas L)、神经元特异性烯醇化酶 (neuron- specific enolase,NSE)的动态变化及其内在联系 ,借此间接了解创伤性脑损伤后神经细胞损伤的规律 ,为探索新的神经保护性治疗措施提供理论依据。方法　选择 35例单纯创伤性颅脑损伤患者 ,依据入院时 GCS(Glasgow coma score)评分将其分为轻型组、中型组和重型组。入选患者分别于伤后2 4 h、72 h、7d、1 4 d抽取外周静脉血 ,运用双抗体夹心酶联免疫分析法 (EL ISA)测定血清中 Fas L、s Fas、NSE含量。结果　 (1 )伤后 2 4 h Fas L、s Fas均升高 ,并于伤后 72 h左右达到高峰 ,后逐渐下降 ,至 2周左右接近正常。 (2 ) NSE于伤后 2 4 h即开始升高 ,且损伤越重升高越显著。 (3) s Fas、Fas L与 NSE呈正相关。结论　 (1 )创伤性脑损伤后神经细胞的损伤存在原发和继发两种机制。 (2 ) Fas/ Fas L系统在继发性脑损伤中起重要作用 ,s Fas的表达增强在一定程度上对神经组织起到保护作用。 (3)创伤性脑损伤后测定血清中 Fas L、s Fas可间接了解继发性脑损伤的程度 ,借此可以为临床探索新的神经保护措施提供理论依据更多还原

【Abstract】 Objective To explore the rule of neuron injury after brain trauma by investigating soluble Fas(sFas),Fas ligand(FasL)and Neuron specific enolase(NSE)in patients’ serum.Methods Thirty five cases of simple traumatic brain injury were selected and divided into minor,moderate and severe groups according to Glasgow coma score(GCS).Serum sFas,FasL and NSE levels were measured at 24 hours,72 hours,7 days and 14 days by Enzyme Linked Immuno Sobent Assay(ELISA).Results (1)Both serum FasL and sFas were significantly elevated and reached the highest level at about 72 hours after brain injury.(2)Elevation of serum NSE was also observed at 24 hours,and the more severe the trauma,the more significant the elevation.(3)Both sFas and FasL correlate positively with NSE( r =0.841,0.847; P <0.01).Conclusion (1)There are primary and secondary neuron injury after brain trauma.(2)The Fas/FasL system play an important role in secondary injury and sFas may prohibit neuron apoptosis in some extent.(3) Measuring serum sFas,FasL can help us to evaluate the degree of secondary neuron injury and provide theoretical basis to explore new method of treatment in brain traumatic patients.更多还原