Predictive value of serum ionized but not total magnesium levels in head injuries
Predictive value of serum ionized but not total magnesium levels in head injuries
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DOI：
10.3109/00365519509075397
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发表时间：
1995-12-01
影响因子：
2.1
通讯作者：
Altura, BM
中科院分区：
文献类型：
--
作者：
Memon, ZI;Altura, BT;Altura, BM
尽管最近有大量关于创伤性脑损伤的文献和研究，但很少适用于在组织水平上诊断和治疗这种综合征。这个问题的一部分是不能使用简单的生化分析物在组织水平上快速和早期评估综合征中脑损伤的程度或进展。考虑到这一点，我们设计了一项研究，在66名人类受试者，谁提出了急性钝性头部创伤，以确定是否游离，离子化血清镁（IMg 2+）和/或游离，离子化血清钙（ICa 2+）水平与头部创伤（HT）的严重程度，以及是否出现任何预测可靠的模式。通过使用一种新的离子选择性电极（伊势）的IMg 2+，我们已经能够确定IMg 2+和ICa 2+在HT后早期（1-8小时）的患者的血清采样后几分钟内。这些研究表明，急性HT与血清IMg 2+的分级缺陷（高达62%，平均值=25%）相关，但与血清总Mg无关，这与基于CT扫描和其他诊断参数的损伤严重程度相关。损伤程度越大，ICa 2 +/IMg 2+比值越大。这些离子发现与头部创伤后早期缺血可能对确定神经系统结果很重要的观点一致。我们的研究结果为创伤性脑损伤后血液中二价阳离子的变化提供了第一个证据，这可能对创伤性脑损伤患者的诊断和预后具有价值。
Despite a wealth of recent literature and research on traumatic brain injury, very little has been applicable to diagnosing and treating this syndrome at a tissue level. Part of this problem is the inability to assess rapidly and early in the syndrome the degree or progression of brain injury at a tissue level using simple biochemical analytes. With this in mind, we designed a study in 66 human subjects, who presented with acute blunt head trauma, to determine whether free, ionized serum magnesium (IMg2+) and/or free, ionized serum calcium (ICa2+) levels correlated with the severity of head trauma (HT) and whether any predictive reliable patterns emerge. By using a new ion-selective electrode (ISE) for IMg2+, we have been able to determine IMg2+ and ICa2+ within minutes after sampling in the serum of patients early (1-8 h) after HT. These studies reveal that acute HT is associated with graded deficits (up to 62%, mean=25%) in serum IMg2+, but not in total serum Mg, which are related to severity of injury based on CT scans and other diagnostic parameters. The greater the degree of injury, the greater the ICa2+/IMg2+ ratio. These ionic findings are compatible with the idea that early ischaemia after head trauma may be important in determining neurological outcome. Our findings provide the first evidence for divalent cation changes in blood after traumatic brain injury, which could be of both diagnostic and prognostic value in patients with traumatic brain injury.