【摘要】 目的探讨颅脑损伤并发脑心综合征患者血乳酸、心肌酶、氧化应激和神经功能指标水平的变化及其临床意义。方法选择2017年1月至2018年12月凉山彝族自治州第二人民医院收治的颅脑损伤并发脑心综合征患者50例作为观察组,另选择未并发脑心综合征的颅脑损伤患者50例作为对照组。使用i-STAT携带式手持血液分析仪测定2组患者动脉血乳酸水平,使用全自动生物化学分析仪测定2组患者血清乳酸脱氢酶(LDH)、α-强酸脱氢酶(α-HBDH)、心肌肌钙蛋白Ⅰ(cTnI)水平,采用酶联免疫吸附试验检测血清丙二醛(MDA)、超氧化物歧化酶(SOD)、血红素加氧酶-1(HO-1)、脑钠肽(BNP)、神经胶质纤维酸性蛋白(GFAP)、神经元特异性烯醇化酶(NSE)水平。结果观察组患者动脉血乳酸水平显著高于对照组(t=32.625,P <0.05),观察组患者血清LDH、α-HBDH、cTnI、BNP水平均显著高于对照组(t=8.361、4.702、29.960、38.175,P <0.05),2组患者血清MDA、SOD、HO-1水平比较差异均无统计学意义(t=1.871、1.063、1.511,P> 0.05),观察组患者血清GFAP和NSE水平显著高于对照组(t=21.893、38.206,P <0.05)。结论颅脑损伤并发脑心综合征患者的血乳酸、心肌酶、神经功能指标水平升高,检测这些指标有助于颅脑损伤患者继发脑心综合征的诊断。更多还原

【Abstract】 Objective To investigate the changes and clinical significance of the levels of blood lactate and the indexes of myocardial enzymes,oxidative stress,neurological function in patients with craniocerebral injury complicated with cerebrocardiac syndrome. Methods Fifty patients with craniocerebral injury complicated with cerebrocardiac syndrome admitted to the Second People’s Hospital of Liangshan Yi Autonomous Prefecture from January 2017 to December 2018 were selected as the observation group,and 50 craniocerebral injury patients without cerebrocardiac syndrome were selected as the control group.The levels of lactate in arterial blood were measured by i-STAT portable hematology analyzer,and the levels of serum lactate dehydrogenase (LDH),α-acidohydrogenase (α-HBDH) and cardiac troponin Ⅰ (cTnI) in were measured by automatic biochemical analyzer. The levels of serum malondialdehyde (MDA),superoxide dismutase (SOD),heme oxygenase-1 (HO-1),brain natriuretic peptide (BNP),GFAP,glial fibrillary acidic protein (GFAP) and neuron-specific enolase (NSE)were detected by enzyme linked immunosorbent assay. Results The level of arterial blood lactic acid in the observation group was significantly higher than that in the control group (t = 32. 625,P < 0. 05). The levels of serum LDH,α-HBDH,cTnI and BNP in the observation group were significantly higher than those in the control group (t = 8. 361,4. 702,29. 960,38. 175; P <0. 05). There was no significant difference in serum MDA,SOD and HO-1 levels between the two groups (t = 1. 871,1. 063,1. 511; P > 0. 05). The levels of serum GFAP and NSE in the observation group were significantly higher than those in the control group (t = 21. 893,38. 206; P < 0. 05). Conclusion The levels of blood lactic acid,myocardial enzymes and nerve function indexes in patients with craniocerebral injury complicated with cerebrocardiac syndrome are increased; and the detection of these indexes is helpful to the diagnosis of secondary craniocerebral syndrome after craniocerebral injury.更多还原