Dynamic Change Of Endogenous H₂s Concentration Of Traumatic Brain Injury Patients And Mechanisms Discussion

Objectives:traumatic brain injury（TBI） is a kind of emergency that threaten human life and its occurrence rate and death and deformity rate rank top one of systematic trauma.The key points deciding patients’ disease condition and prognosis are the severity of primary injury and the severity of secondary injury caused by primary injury. By determining H₂S concentration in the plasma and cerebrospinal fluid of TBI patients at different times after being injured, this paper is to discuss the relation between H₂S concentration and the severity of craniocerebral injury and its role in the occurrence and development of secondary craniocerebral injury and to provide new idea for clinical treatment by monitoring the disease development through its dynamic change rule.Methods:90 patients with traumatic craniocerebral injury that had been admitted in the emergency department of First Hospital of Shan’xi Medical University from Aprial2015 to December 2015 were selected as study objects. These patients were divided into light, medium and severe type, including 36 cases of light type, 24 cases of medium type and 30 cases of severe type. The other 35 non-TBI patients who have been excluded the possibility of TBI disease by lumbar puncture were taken as the control group. The blood and cerebrospinal fluid liquid samples of TBI patients from three groups at 6h, 12 h, 1d, 2d, 3d, 5d, 7d after being injury were collected and the blood and cerebrospinal fluid liquid sample of the control group was collected.Modified methylene blue spectrophotometric method was adopted to determine H₂S concentration in the sample. SPSS 20.0 statistics software was adopted to analyze the relation between H₂S concentration in the plasma and cerebrospinal fluid liquid and the severity of craniocerebral injury, to get to know the dynamic change trend and make clear the relevance between H₂S concentration in the plasma and in the cerebrospinal fluid.Results:H₂S concentration in the plasma of patients with light, medium and severe type of traumatic craniocerebral injury at each time was in a declining trend comparing with the control group and two-two comparison difference had statistical significance（P<0.05）; H₂S concentration in the cerebrospinal fluid liquid of patients with light,medium and severe type of traumatic craniocerebral injury at each time was in a declining trend comparing with the control group and two-two comparison difference had statistical significance（P<0.05）; H₂S concentration in the plasma and cerebrospinal fluid liquid of patients with medium and severe type of traumatic craniocerebral injury was in a dynamic trend with the development of disease course,declining after being injured, reaching the minimum value at 1d after being injured,gradually increasing after that and then going back to the same level of 6h at the 7d;while this kind of trend was not evident in the light type group; H₂S concentration in the plasma of patients with light, medium and severe type of traumatic craniocerebral injury was positively related to H₂S concentration in their cerebrospinal fluid liquid and H₂S concentration in the plasma of TBI patients with the same type was higher than H₂S concentration in the plasma and the difference had statistical significance（P<0.05）.Conclusion:H₂S concentration in the plasma of patients with traumatic craniocerebral injury was negatively related to the severity of craniocerebral injury, that is, the more serious the injury degree, the lower the H₂S concentration in the plasma and cerebrospinal fluid liquid of patients; H₂S concentration in the plasma and cerebrospinal fluid liquidof patients with medium and severe type of traumatic craniocerebral injury was in a dynamic trend with the development of disease course, declining after being injured,reaching the minimum value at 1d after being injured, gradually increasing after that and then going back to the same level of 6h at the 7d; H₂S concentration in the plasma of patients with light, medium and severe type of traumatic craniocerebral injury was positively related to H₂S concentration in their cerebrospinal fluid liquid and H₂S concentration in the plasma of TBI patients with the same type was higher than H₂S concentration in the plasma, which indicates that H₂S may involve the occurrence and development of secondary craniocerebral injury and play an role in it. Besides, its dynamic change trend provides new indexes and evidence for monitoring disease development and guiding clinical treatment.