颅脑损伤患者外周血髓过氧化物酶的变化及临床意义

摘要

Objective To explore the clinical dynamic changes of serum myeloperoxidase (MPO) in patients with traumatic brain injury. Methods 90 cases of patients with traumatic brain injury were divided into three groups(mild, medium and severe injury group) based on the GCS scores. The activity of MPO in serum by colorimetry,the amount of white blood cell,the amount and ratio of neutrophil were determined and analyzed at 3h,6h,12h,24h,48h,72h after injury,respectively. Results The serum MPO activity, the amount of white blood cell,the amount and ratio of neutrophil had a positive correlation with the GCS scores. As the disease developed,the activity of MPO in each injury group was changed. It was increased at 3h after injury and reached peak value at 12h, and then gradually decreased. It was decreased to the level of the injury commencement after 72h. The activity of serum MPO had a positive correlation only with the ratio of neutrophil,and the ather three had no significant changes in the development of the disease. Conclusion The activity of serum MPO could sensitively showed the development of the disease. And dynamic observation of the changes of MPO may be used to judge the severity and therapy in patients with traumatic brain injury.%目的 研究颅脑损伤患者血清髓过氧化物酶(serum myeloperoxidase,MPO) 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.测定颅脑损伤患者伤后3、6、12、24、48、72 h血清中MPO活性(比色法)、血液白细胞数(WBC)、中性粒细胞数(neutrophil,NEUT#)、中性粒细胞比值(neutrophil ratio,NEUT%),并作相关分析.结果 颅脑外伤患者血清MPO活性、WBC、NEUT#、NEUT%与患者的损伤程度呈正相关.不同损伤程度患者血清MPO活性均受病情进程的影响(P＜0.01),随病情发展伤后3 h血清MPO活性开始增加,于12 h达高峰,以后逐步下降,72 h后降至受伤时水平,只有轻度患者可降至正常水平.颅脑损伤患者外周血MPO活性只与NEUT%存在正相关性(P＜0.01),且其他三者不受病情进程的影响.结论 血清MPO活性更能敏感地表现出颅脑损伤患者随病情发展的变化,监测患者血清MPO活性并进行动态观察对病情的评估及治疗有指导作用.