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目的研究颅脑损伤患者血清同型半胱氨酸(serum homocysteine,Hcy)活性的动态变化及临床意义。方法90例颅脑损伤患者按照GCS评分将患者分为轻度损伤(13～15分)29例,中度损伤(9～12分)29例,重度损伤(3～8分)32例,36例健康体检者为对照组。测定颅脑损伤患者伤后3、6、12、24、48、72h血清中Hcy水平。结果颅脑损伤患者伤后3h以内血清Hcy水平比正常对照组高(P<0.01),且均与患者的病情呈正相关。不同损伤程度血清Hcy水平均受病情进程的影响(P<0.01),随病情发展伤后3h血清Hcy水平增加,但随后开始下降,于12h降至底峰,以后逐步上升,24h后一直维持于一高水平,至72h也未见下降。结论颅脑损伤患者血清Hcy水平升高,且与病情的严重程度呈正相关。而且损伤早期还与病程发展有关,这对病情的评估及治疗方案的选择有一定的指导作用。
Objective To study the dynamic changes of serum homocysteine (Hcy) activity in patients with craniocerebral injury and its clinical significance. Methods Ninety-nine patients with mild injury (9-12), 32 patients with severe injury (3-8), 36 patients with moderate injury (3-8), 36 patients with severe injury (3-8) Cases of health examination for the control group. The level of Hcy in the serum of 3, 6, 12, 24, 48, 72 h after traumatic brain injury was measured. Results The level of serum Hcy within 3 hours after traumatic brain injury was higher than that of normal control group (P <0.01), and both were positively correlated with the patient’s condition. Serum Hcy levels at different degrees of injury were affected by the course of the disease (P <0.01). Serum Hcy levels increased at 3 hours after injury, but then began to decline. The level of Hcy dropped to the bottom peak at 12 hours and then gradually increased after 24 hours A high level, no decline to 72h. Conclusion Serum Hcy levels in patients with craniocerebral injury increased, and the severity of the disease was positively correlated. And early injury also associated with the development of the disease, which evaluation of the disease and the choice of treatment options have a guiding role.