早期顱腦損傷后血磷、血清胰島素、血糖的變化及臨床研究

[摘要]目的 探討血磷、血清胰島素、血糖的變化與顱腦損傷的關(guān)系及臨床意義。方法 應(yīng)用鉬銅藍(lán)染色法、放射免疫、生化分析測125例顱腦損傷患者血磷濃度、血清胰島素、血糖的變化情況并與對照組比較。結(jié)果 顱腦損傷組早期血磷明顯低于對照組，而血清胰島素、血糖高于對照組，上述變化越明顯，患者預(yù)后越差。結(jié)論 顱腦損傷早期體內(nèi)血磷明顯下降，血清胰島素，血糖則明顯升高。且變化大小與預(yù)后呈正相關(guān)。

[關(guān)鍵詞] 顱腦損傷;血磷;血清胰島素;血糖

[中圖分類號] R651.1+5[文獻(xiàn)標(biāo)識碼] A[文章編號] 1004-8650(2009)07-018-02

Clinical Study on the Change of Serum Phosphorus， Serum Insulin and Blood Glucose after Early Brain Injury

XIAO Ming-li

(Three Gorges Medicine College， Chongqing 404000)

[Abstract] Objective To discuss the relationship between brain injury and the change of serum phosphorus， serum insulin and blood glucose. Methods 125 patients’ serum phosphate concentration， serum insulin and blood glucose were measured by molybdenum-copper blue stain-method， radioimmunoassay and biochemical analysis. The results were compared with control group. Results Brain injury group’s early serum phosphorus was obviously lower than control group， but their serum insulin and blood glucose were higher than control group. Conclusion In early stage of brain injury， patients’ serum phosphorus were obviously decreased， while serum insulin and blood glucose were markedly increased. The change conditions was positively correlated with prognosis.

[Key words] brain injury; serum phosphorus; serum insulin; blood glucose

1資料與方法

1.1臨床資料

重型顱腦損傷共125例，男80例，女45例，年齡5-78歲，平均年齡36.7歲，傷后8-12小時入院，均經(jīng)過CT、MRI、血管造影及手術(shù)證實。硬膜外、下血腫55例，腦內(nèi)血腫50例，腦挫裂傷及腦干損傷20例，顱腦損傷程度按GCS評分3-5分25例，6-8分48 例，9-12分40 例，13-15分12 例。治療:93 例行顱腦血腫清除及壞死腦組織清除，其余采用保守療法，治療結(jié)果使用GOS評分，良好組60例，中殘20例，重殘10例，死亡35例。

1.2檢測方法

患者入院后20小時內(nèi)抽血，運(yùn)用鉬銅藍(lán)染色法測血磷，使用放射免疫測血清胰島素，采用美國公司生化分析測血糖的變化情況。數(shù)據(jù)采用t檢驗進(jìn)行統(tǒng)計處理。對照組52人，男30人，女22人，均為體檢健康者。

2結(jié)果

2.1顱腦損傷后血磷、血清胰島素、血糖的變化

從表1中可以看出硬腦膜外、下血腫，腦內(nèi)血腫，腦挫裂傷及腦干損傷出現(xiàn)后，血磷下降，血清胰島素、血糖均有不同程度升高，與對照組相比均有統(tǒng)計學(xué)意義。

2.2血磷肥、血清胰島素、血糖改變與預(yù)后關(guān)系，見表2。……