南方医科大学学报

南方医科大学学报 ›› 2006, Vol. 26 ›› Issue (05): 703-704.

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颅脑损伤患者血液及脑脊液中IgG含量的变化与病情的关系

李卫； 徐如祥； 张建； 陈善成； 法志强； 张梅；   

  1. 南方医科大学珠江医院神经外科； 暨南大学附属第一临床学院神经外科； 广州医学院 广东广州510282暨南大学附属第一临床学院神经外科； 广东广州510630； 广东广州510282； 广东广州510000；
  • 出版日期:2006-05-20 发布日期:2006-05-20

Association of blood and cerebrospinal fluid IgG contents and severity of craniocerebral injury

LI Wei1,2,XU Ru-xiang1,ZHANG Jian2,CHEN Shan-cheng2,FA Zhi-qiang2,ZHANG Mei3 1Department of Neurosurgery,Zhujiang Hospital,Southern Medical University,Guangzhou 510515,China;2Department of Neurosurgery,First Affiliated Hospital,Ji’nan University,Guangzhou 510630,China;3Guangzhou Medical College,Guangzhou 510000,China   

  1. 南方医科大学珠江医院神经外科； 暨南大学附属第一临床学院神经外科； 广州医学院 广东广州510282暨南大学附属第一临床学院神经外科； 广东广州510630； 广东广州510282； 广东广州510000；
  • Online:2006-05-20 Published:2006-05-20

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摘要： 目的了解血液及脑脊液中IgG含量与颅脑损伤患者病情之间的关系。方法143例颅脑损伤患者,根据Glasgow昏迷评分分为:轻型(12～15分)41例;中型(9～11分)71例;重型(3～8分)32例。另选择9例先天性脑积水患者作为对照。分别于第4天、14天、1个月、2个月及半年5个时间点,采集患者脑脊液及血液,检测免疫球蛋白IgG含量,并根据残疾等级评分(DRS)对患者的残疾程度进行评估,分析两者间的相关程度。结果中、重型颅脑损伤患者早期血液中IgG含量下降,而脑脊液中IgG含量上升,与对照组比较有显著差异(P<0.05),其变化幅度与病情的轻重密切相关(r=0.950,P<0.01);在重型颅脑损伤患者的恢复期(14d以后),与血液中IgG含量呈负相关关系,而与脑脊液IgG含量正相关关系。结论颅脑损伤患者早期检测血液中IgG含量可以判断病情的轻重,恢复期动态检测血液及脑脊液中IgG含量可以了解病情的转归,修改治疗方案。 

Abstract: Objective To explore the association of blood and cerebrospinal fluid(CSF)IgG contents and the severity of craniocerebral injury.Methods Totalling 143 patients with craniocerebral injury were divided into 3 groups according Glasgow Coma Scale(GCS)scores,namely the mild injury group with GCS score of 12-15(n=41),moderate injury group with GCS score of 9-11(n= 71)and severe injury group(GCS score 3-8,n=32).Another 9 patients with congenital hydrocephalus were also recruited as the control group.The CSF and blood samples were collected from these patients to measure the IgG contents 4 and 14 days and 1,2,and 6 months after the injury,respectively.Physical disabilities of the patients were estimated with Rappaport’s disability rating scale(DRS),whose correlations with CSF and blood IgG contents were analyzed.Results In the early stage of moderate to severe brain injury,the IgG content was lowered significantly in the blood but increased in CSF as compared with the control patients(P<0.05),and the changes in CSF and blood IgG displayed a significant correlation with the severity of the injury(r=0.950,P<0.01).During the recovery of severe brain injury,DRS score was in inverse correlation with blood IgG content but in positive correlation with CSF IgG content(Spearman’s correlation coefficient of 0.800,P<0.05).Conclusion In the early stage of brain injury,detection of blood IgG content may help with the assessment of the injury severity.During the recovery of the injury,dynamic monitoring of blood and CSF IgG contents provides clues of the outcome of the patients and benefit the modification of the treatment plan.

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