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目的目前对于脑瘫与脑内神经递质的关系研究很少,该研究通过测定不同类型脑瘫患儿脑脊液中谷氨酸、天冬氨酸、γ-氨基丁酸的含量,以了解不同类型脑瘫患儿脑脊液中氨基酸变化。方法选取13例痉挛型脑瘫患儿、14例徐动型脑瘫患儿及同期已排除神经系统疾病和感染性疾病的10例手术患儿,分别设为痉挛组、徐动组和对照组。每1例均于手术麻醉前自腰椎3,4椎间隙穿刺取无血污脑脊液2 mL,取上清液用高效液相色谱-荧光法测定谷氨酸、天冬氨酸、γ-氨基丁酸含量。结果①对照组脑脊液中γ-氨基丁酸、天冬氨酸、谷氨酸分别为13.04±2.19μmol/L,10.21±0.45μmol/L,8.41±2.26μmol/L;与对照组比较,痉挛型脑瘫患儿脑脊液中γ-氨基丁酸显著降低为8.02±2.03μmol/L,(P<0.01),谷氨酸、天冬氨酸显著增高为20.99±8.15μmol/L、13.53±3.93μmol/L(P<0.05,P<0.01);徐动型脑瘫脑脊液中γ-氨基丁酸显著降低为10.01±2.68μmol/L(P<0.01),谷氨酸、天冬氨酸显著增高为28.77±17.62μmol/L,14.02±2.88μmol/L(P<0.01)。痉挛型脑瘫与徐动型脑瘫比较,痉挛型脑瘫患儿脑脊液中γ-氨基丁酸显著降低,而谷氨酸、天冬氨酸含量两者差异无显著性(P>0.05)。②线性相关分析发现痉挛型脑瘫患儿脑脊液中谷氨酸的水平与肌张力呈等级正相关;γ-氨基丁酸和天冬氨酸的水平与肌张力无相关性。结论脑瘫患者脑脊液中兴奋性氨基酸含量较正常儿童增高,抑制性氨基酸含量较正常儿童降低,且不同类型脑脊液中氨基酸含量存在差异,氨基酸水平的改变可能是脑瘫患儿的病理改变的基础之一。
Objective To study the relationship between cerebral palsy and neurotransmitter in the brain, few studies have been conducted to determine the contents of glutamic acid, aspartic acid and γ-aminobutyric acid in cerebrospinal fluid of children with different types of cerebral palsy. Amino acid changes in cerebrospinal fluid. Methods Thirteen children with spastic cerebral palsy, 14 children with Xu cerebral palsy and 10 children with neurological diseases and infectious diseases who had been excluded during the same period were selected as spasticity group, Xu-action group and control group respectively. 2 cases of non-blood-flushed cerebrospinal fluid were punctured from the lumbar spine 3 and 4 intervertebral space before surgical anesthesia. The supernatant was taken for determination of glutamic acid, aspartic acid and γ-aminobutyric acid by high performance liquid chromatography-fluorescence method content. Results ① The concentrations of γ-aminobutyric acid, aspartic acid and glutamic acid in cerebrospinal fluid of control group were 13.04 ± 2.19μmol / L, 10.21 ± 0.45μmol / L and 8.41 ± 2.26μmol / L, respectively. Compared with the control group, spasticity Cerebrospinal fluid in children with cerebral palsy significantly decreased γ-aminobutyric acid was 8.02 ± 2.03μmol / L, (P <0.01), glutamate, aspartate significantly increased 20.99 ± 8.15μmol / L, 13.53 ± 3.93μmol / L (P <0.05, P <0.01). The concentration of γ-aminobutyric acid in cerebrospinal fluid of patients with Xuate cerebral palsy was significantly decreased to 10.01 ± 2.68μmol / L (P <0.01), while that of glutamate and aspartate increased significantly to 28.77 ± 17.62 μmol / L, 14.02 ± 2.88 μmol / L (P <0.01). Spastic cerebral palsy compared with Xu actic cerebral palsy, cerebrospinal fluid in children with spastic cerebral palsy significantly decreased γ-aminobutyric acid, while glutamic acid, aspartic acid content of the two was no significant difference (P> 0.05). ② Linear correlation analysis found that cerebrospinal fluid of children with spastic cerebral palsy had a positive correlation between levels of glutamic acid and muscle tone. The levels of γ-aminobutyric acid and aspartic acid did not correlate with muscle tone. Conclusions The content of excitatory amino acid in cerebrospinal fluid of cerebral palsy patients is higher than that in normal children, and the content of inhibitory amino acids is lower than that in normal children. There is difference in amino acid content among different types of cerebrospinal fluid. The change of amino acid level may be the basis of the pathological changes in children with cerebral palsy.