闭合性颅脑损伤患者脑脊液氧化脂质代谢物的特征及临床意义

doi:10.3877/cma.j.issn.2095-123X.2019.04.003

中华脑科疾病与康复杂志(电子版) ›› 2019, Vol. 09 ›› Issue (04) : 201 -204. doi: 10.3877/cma.j.issn.2095-123X.2019.04.003

所属专题：文献；

临床研究

闭合性颅脑损伤患者脑脊液氧化脂质代谢物的特征及临床意义

邹创欢¹, 金法², 龙定超¹^,^†(

)

^1. 511400　广州，番禺区第八人民医院神经外科
^2. 510220　广州，南方医科大学珠江医院神经外科

收稿日期:2019-07-05 出版日期:2019-08-15
通信作者: 龙定超

Characteristics and clinical significance of oxidized lipid metabolites in cerebrospinal fluid in patients with closed craniocerebral injury

Chuanghuan Zou¹, Fa Jin², Dingchao Long¹^,^†()

^1. Department of Neurosurgery, The 8th People Hospital of Panyu District, Guangzhou 511400, China
^2. Department of Neurosurgery, Zhujiang Hospital of Southern Medical University, Guangzhou 510220, China

Received:2019-07-05 Published:2019-08-15
Corresponding author: Dingchao Long
About author:
Corresponding author: Long Dingchao, Email: wcrmcm@sina.com

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目的

研究闭合性颅脑损伤患者脑脊液氧化脂质代谢物的特征及临床意义。

方法

选取广州番禺区第八人民医院神经外科及珠江医院神经外科自2018年1月至12月选择闭合性颅脑损伤患者60例，按照GCS评分标准分为轻型组（GCS 13~15分）、中型组（GCS 8~12分）、重型组（GCS 3~7分），每组20例；随机选取20例健康成年人脑脊液作为对照组。所有脑脊液样本进行氧化脂质代谢物液相质谱法检测，并在治疗后第6个月时采用美国国立卫生研究院卒中量表（NIHSS）评分评估所有患者的临床预后，分析各组脑脊液样本的氧化脂质代谢物差异特征及其与患者NIHSS评分的相关性。

结果

闭合性颅脑损伤患者共检测到3个水平升高代谢物、5个水平降低代谢物（FC≥1，P<0.05），水平升高的氧化脂质代谢物为LTB4、5-oxoETE、15-oxoETE，水平降低的氧化脂质代谢物为PGJ2、LXA4、PGF3α、TXB3、RVD5。其中，仅15-oxoETE的变化趋势与病情严重程度存在依赖性（P<0.05）。氧化脂质代谢物15-oxoETE与临床预后NIHSS评分呈显著正相关（r>0，P<0.05）。

结论

闭合性颅脑损伤患者脑脊液氧化脂质代谢物发生了显著变化，其中显著增高的15-oxoETE水平对临床预后较差有预示作用。

关键词: 闭合性颅脑损伤, 氧化脂质代谢, 脂质介质

Objective

To explore the characteristics and clinical significance of oxidized lipid metabolites in cerebrospinal fluid in patients with closed craniocerebral injury.

Methods

During the period of January 2018 to December 2018, according to GCS score, 60 patients with closed craniocerebral injury were divided into light group (GCS 13-15 score), medium group (GCS 8-12 score) and heavy group (GCS 3-7 score), 20 cases in each group, and randomly selected 20 cases of health adult as normal group. All cerebrospinal fluid samples were detected by chromatography-electrospray mass spectrometry, and the clinical prognosis of all patients was evaluated by National Institute of Health stroke scale (NIHSS) score at the 6^th month after treatment, and the difference characteristics of oxidized lipid metabolites in each group of cerebrospinal fluid samples and their correlation with NIHSS score were calculated and analyzed.

Results

Three levels of increased metabolites and five levels of decreased metabolites (FC≥1, P<0.05) were detected in patients with closed craniocerebral injury. The level of increased oxidative lipid metabolites were LTB4, 5-oxoETE and 15-oxoETE, and the level of decreased oxidative lipid metabolites were PGJ2, LXA4, PGF3, TXB3 and RVD5. Among them, only 15-oxoETE was dependent on the severity of the disease (P<0.05). There was a significant positive correlation between 15-oxoETE and NIHSS (P<0.05).

Conclusion

The level of oxidized lipid metabolites in cerebrospinal fluid of patients with closed craniocerebral injury has a significant change, and the significantly increased level of 15-oxoETE has a predictive effect on the poor clinical prognosis.

Key words: Craniocerebral injury, Oxidized lipid metabolism, Lipid mediator

表1 4组患者基本信息对比

组别	例数	性别（男/女）	年龄（岁，Mean±SD）
轻型组	20	12/8	39.15±15.23
中型组	20	9/11	39.70±10.78
重型组	20	13/7	39.65±15.09
对照组	20	10/10	40.80±12.82
χ²/F值	?	2.020	0.052
P值	?	0.568	0.984

表1 4组患者基本信息对比

组别	例数	性别（男/女）	年龄（岁，Mean±SD）
轻型组	20	12/8	39.15±15.23
中型组	20	9/11	39.70±10.78
重型组	20	13/7	39.65±15.09
对照组	20	10/10	40.80±12.82
χ²/F值	?	2.020	0.052
P值	?	0.568	0.984

图1 4组患者的脑脊液中氧化脂质代谢物变化特征

图2 氧化脂质代谢物15-oxoETE与NIHSS评分相关性分析

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[1]	王昊, 朱细燕, 向洪义, 廖志康, 高谋, 张溢华, 张景宇, 许明伟, 张楠, 徐伦山, 赵辉, 许民辉. 急进高原轻-中度闭合性颅脑损伤后在不同海拔下伤情变化的观察[J]. 中华神经创伤外科电子杂志, 2019, 05(01): 33-39.

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Characteristics and clinical significance of oxidized lipid metabolites in cerebrospinal fluid in patients with closed craniocerebral injury

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Characteristics and clinical significance of oxidized lipid metabolites in cerebrospinal fluid in patients with closed craniocerebral injury