Cerebrospinal fluid magnesium level as a prognostic factor in ischaemic stroke
Cerebrospinal fluid magnesium level as a prognostic factor in ischaemic stroke
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DOI：
10.1007/s004150050249
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发表时间：
1998-09-01
影响因子：
6
通讯作者：
Sarova-Pinhas, I
中科院分区：
文献类型：
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作者：
Lampl, Y;Geva, D;Sarova-Pinhas, I
据报道，镁对脑动脉有扩张作用。细胞外 Mg+2 的减少已被证明与脑痉挛的强度直接相关。还假设镁对中风具有神经保护作用。我们研究的目的是检测中风早期血清和脑脊液 (CSF) 中的 Mg+2 水平，并评估 Mg+2 水平与神经功能缺损发展之间的相关性。 1986 年至 1994 年间，96 名中风持续时间为 24 至 48 小时的患者参加了这项研究。入院时、中风发作后 24-48 小时检查血清和脑脊液镁水平。使用神经评分，在第一天、1周和4周后评估神经功能缺损。 1周后进行计算机断层扫描（CT），计算并测量梗塞的体积和位置。使用 Spearman 相关性以及多元线性和逻辑回归分析，分别对皮质和皮质下患者进行统计分析。 CSF Mg+2 与梗塞面积之间存在显着相关性 (P < 0.0001)。血清 Mg+2 和脑脊液 Mg+2 水平之间没有相关性。回归分析表明，随着 CSF Mg+2 水平的升高，Mathew 神经评分值也随之增加。在回归模型考虑了年龄、相关心脏病、糖尿病和梗塞面积等其他因素后，这种关联仍然存在。结果证实，缺血性中风发病后 48 小时内脑脊液中的低 Mg+2 浓度与神经功能缺损的强度之间存在相关性。这一发现的治疗结果可能具有一定的重要性。
Magnesium has been reported to have a dilatatory effect on cerebral arteries. Reduction of extracellular Mg+2 has been shown to be directy correlated with the intensity of cerebral spasm. A neuroprotective effect of magnesium in stroke has also been hypothesized. The aim of our study was to examine the Mg+2 levels in serum and cerebrospinal fluid (CSF) in the early stage of stroke and to evaluate the correlation between Mg+2 levels and the development of neurological deficits. Between 1986 and 1994, 96 patients who had a stroke of 24- to 48-h duration were enrolled in the study. Serum and CSF levels of magnesium were checked on admission, 24-48 h after the onset of stroke. Using a neurological score, the neurological deficit was assessed on the Ist day, 1 and 4 weeks later. Computed tomography (CT) was performed after 1 week, and the volume and location of infarction were calculated and measured. Statistical analysis was performed for cortical and subcortical patients separately, using Spearman correlation and multiple linear and logistic regression analyses. Significant con-elation was found between CSF Mg+2 and the size of the infarct (P < 0.0001). There was no correlation between serum Mg+2 and CSF Mg+2 levels. Regression analysis demonstrated an increase in the values of the Mathew Neurological Score with higher CSF Mg+2 levels. This association remained true after other factors such as age, associated heart disease, diabetes and infarction size had been taken into account by the regression model. The results confirm that there is a relationship between a low Mg+2 concentration in CSF during the first 48 h after onset of ischaemic stroke and the intensity of the neurological deficit. The therapeutic consequence of this finding may have some importance.