背景:近年来的研究表明,S100蛋白质类和神经元特异性烯醇化酶的血清浓度与脑损害的程度呈正相关,用于评价脑损伤的程度和预后,但血清S100蛋白质类和磷酸丙酮酸水合酶水平是否可作为评价糖皮质激素对中枢神经系统损伤有治疗作用的指标.目的:观察血清S100蛋白质类和磷酸丙酮酸水合酶变化,探讨甲基强的松龙对大鼠颅脑损伤的治疗作用.设计:随机对照实验.单位:中山大学附属第一医院.材料:实验于2003-09在广州医学院神经研究所完成.选择SD大鼠72只.方法:将72只SD大鼠随机分为3组,正常组8只,对照组和治疗组大鼠各32只,对照组和治疗组分别分为伤后1,6,12,24 h组,每个小组8只.①造模:采用Feeney法造成鼠脑挫裂伤模型后,正常组只行开颅手术,不作头颅打击.②给药及取材:治疗组大鼠致伤后即刻腹腔内注射30 mg/kg甲基强的松龙,对照组则即刻腹腔内注射30 mg/kg生理盐水.正常组不注射药物,开颅后随即断头取血;对照组和治疗组大鼠分别在伤后1,6,12,24 h时间点断头取血,离心后取上清液,用酶联免疫吸附法作血清S100蛋白质类和磷酸丙酮酸水合酶水平检测.主要观察指标:①各组大鼠血清S100蛋白质类水平.②各组大鼠血清磷酸丙酮酸水合酶水平.结果:72只大鼠均进入结果分析.①正常组血清S100蛋白质类(0.35±0.029)μg/L,除伤后24 h治疗组血清S100蛋白质类与正常组无差异外,对照组和治疗组血清S100蛋白质类水平均比正常组高(P＜0.01或P＜0.05);治疗组在伤后6,12 h和24 h比对照组血清S100蛋白质类低(P＜0.01或P＜0.05).②正常组血清磷酸丙酮酸水合酶(8.35±1.01)μg/L,除伤后24 h对照组和治疗组血清磷酸丙酮酸水合酶与正常组无差异外,其余时间点对照组和治疗组血清磷酸丙酮酸水合酶水平均比正常组高(P＜0.01);治疗组在伤后1,6,12 h时间点比对照组血清磷酸丙酮酸水合酶低(P＜0.01或P＜0.05).结论:大鼠颅脑损伤后血清S100蛋白质类和磷酸丙酮酸水合酶可以作为反映脑损伤程度的标志物,甲基强的松龙对损伤的脑组织有治疗作用.%BACKGROUND: In recent researches the concentration of S100 proteins and neuron-specific enolase have been proved positively correlated with the degree of brain injury, and can be used for assessing the degree and prognosis of brain injury. But whether the level of serum S100 proteins and phosphopyruvate hydratase can predict the role of glucocorticosteroid in the treatment of CNS damage is unclear.OBJECTIVE: To observe the changes of serum S100 proteins and phosphopyruvate hydratase level, aiming to explore the role of methylprednisolone in the treatment of craniocerebral inju ryin rats.DESIGN: Randomized controlled study.SETTING: The First Affiliated Hospital of Sun Yat-sen University.MATERIALS: This study was carried out at the Neurological Research Institute of Guangzhou Medical College in September 2003. Totally 72 SD rats were enrolled in this study.METHODS: Totally 72 SD rats were randomly divided into three groups,namely normal group of 8 rats, comparison group and treatment group of 32 rats respectively, the latter two groups were then subdivided into post-trautablishment: Brain contusion and laceration was made in rats according to Feeney's method, rats in normal group were only subjected to craniotomy group, rats were given intraperitoneal injection of methylprednisolone by dosage of 30 mg/kg instantly after injury, which replace by physical saline of the same dosage in comparison group. Rats in normal group were not given intraperitoneal injection, blood specimen was obtained instantly after put to death by cutting off head; in comparison group and treatment group,blood sample was obtained from rat at post-traumatic 1, 6, 12 and 24 hours and centrifuged for collecting superuatant, the level of serum S100 proteins and phosphopyruvate hydratase was detected by using ELISA method.RESULTS: Totally 72 rats were enrolled in this experiment and all regroup was (0.35±0.029) μg/L. The difference of serum S100 proteins was not obvious between normal group and treatment group at post-traumatic 24 hours, but the level of S100 proteins in treatment group and comparison group was significantly higher than normal group (P ＜ 0.01 or P ＜ 0.05);moreover in contrast with comparison group, the level of S100 proteins was found obviously lower in treatment group at post-traumatic 6, 12 hours and hydratase was (8.35±1.01) μg/L in normal group, the difference of serum phosphopyruvate hydratase level between comparison group and treatment group was higher than normal group, displaying statistical significance at all post-traumatic time points (P ＜ 0.01), except for not obvious difference between comparison group at post-traumatic 24 hours and treatment group.While comparing to comparison group, the level of serum phosphopyruvate hydratase was found obviously lower in treatment group at post-traumatic 1,6 and 12 hours time point (P ＜ 0.01 or P ＜ 0.05).CONCLUSION: The level of serum S100 proteins and phosphopyruvate hydratase can be used as predictors for the degree of brain injury in rats, in addition methylprednisolone might exert therapeutic effect on traumatic brain.
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