重复经颅磁刺激对创伤性颅脑损伤患者脑脊液中兴奋性氨基酸含量的影响

目的：探讨重复经颅磁刺激（rTMS）对急性颅脑损伤患者脑脊液中兴奋性氨基酸（EAA）含量的影响。方法：30例创伤性颅脑损伤（TBI）病人按格拉斯哥昏迷评分分为轻型组（rTMS3）、中型组（rTMS2）、重型组（rTMS1）,每组10例,各组病人分别随机分为rTMS对照亚组（A组）及治疗亚组（B组）,每亚组5例。于TBI后第15天行腰椎穿刺采集脑脊液,采用高效液相色谱法测定脑脊液中谷氨酸（ASP）及门冬氨酸（GLU）含量。结果：脑脊液ASP和GLU水平随着脑损伤程度的加重而升高,各rTMS治疗组与相应各对照组的EAA相比,rTMS治疗组EAA的水平均低于相应对照组。结论：rTMS可通过降低TBI后脑脊液EAA水平发挥脑保护作用。脑脊液EAA的含量变化可作为TBI严重程度的生化指标。

Effect of repetitive transcranial magnetic stimulation on excitatory amino acids in cerebrospinal fluid of traumatic cerebral injury patients

Objective：To observe the excitatory amino acids（glutamate and aspartate） in cerebrospinal fluid with the method of rTMS in traumatic cerebral injury patients.Methods：30 patients with TBI were divided into 3 groups according to Glasgow score,those were mild（rTMS3）,moderate（rTMS2）,and severe（rTMS1） group,10 patients every group.Every group was randomized into treatment subgroup（subgroup B,with rTMS treatment,） and control subgroup（subgroup A,with traditional treatment）,5 patients each subgroup.Cerebrospinal fluid samples were collected by lumbar puncture 15 days after TBI.Concentration of glutamate（GLU） and aspartate（ASP） were measured by means of high-performance liquid chromatography.Results：GLU and ASP in spinal fluid were higher correlate with the severity of TBI.ASP and GLU in rTMS treatment subgroup in every group were lower than those in control subgroup in every group.Conclusions：rTMS treatments may protect brain through decreasing EAA concentration in CSF.Concentration of EAA in CSF maybe biochemical parameters to evaluate the severity of TBI.