环丙沙星对脑脊液氨基酸神经递质含量影响的研究 (pdf)

    【摘要】 目的 观察静滴环丙沙星(CPLX)后患者CSF中抑制性氨基酸(GABA、Gly)和兴奋性氨基酸(Asp、Glu)含量的变化，探讨 CPLX致痫的发生机制。方法 患者静脉滴注CPLX 200mg/次，给药后60min记录脑电图，于用药前作脊髓穿刺，抽取CSF作为对照，用药后120min时抽取CSF作为试验样本，用高效液相色谱法测定CSF中氨基酸的含量。结果 静滴CPLX后可引起患者CSF中抑制性氨基酸和兴奋性氨基酸的含量发生明显的变化。用药后120min时，CSF中GABA含量为2.15±0.88μmol/L，明显高于用药前的0.62±0.18μmol/L(P<0.01)，而Asp、Glu、Gly的含量分别为10.32±2.89μmol/L、9.02±5.46μmol/L、16.73±3.95μmol/L，均明显低于用药前的15.67±4.21μmol/L、15.11±6.24μmol/L、21.78±7.21μmol/L (P<0.05～0.01)。6/21的病例脑电图出现异常波，其中1例出现频发棘波。结论 CPLX明显影响了中枢神经系统内氨基酸---神经递质的代谢平衡,导致患者神经系统不良反应，氨基酸含量的变化并可通过CSF反映出来。

    【关键词】 氨基酸神经递质；脑脊液；高效液相色谱；环丙沙星

    Study on the changes of concentration of amino acids neurotransmitter in the CSF induced by ciprofloxacin

    ZHOU Yi-wen,YUAN Ze, TU Zhi-guang.

    Department of Laboratory, Shenzhen Cardiovascular Hospital,Shenzhen 518035, China

    【Abstract】 Objective To evaluate the changes of concentration of inhibitory and excitatory amino acids neurotransmitter (Asp, Glu, GABA, Gly) in the CSF after intravenous drip ciprofloxacin (CPLX), and conduct an investigation into the pathogenic mechanism of epilepsy induced by CPLX. Methods The intravenous drip ciprofloxacin 200mg.time-1 to volunteers, before dosage, the CSF of volunteers was taken out as control, electroencephalogram (EEG) was recorded at 60 min after dosage, then the CSF of volunteers was taken out again at 120min after administration as experimental samples, and the amino acids were detected with high performance liquid chromatography.Results The concentration of inhibitory and excitatory amino acids in the CSF was obviously changed after dosage. At 120min after administration, the concentration of GABA(2.15±0.88μmol/L) was significantly higher than before dosage (0.62±0.18μmol/L, P<0.01), and Asp, Glu and Gly (10.32±2.89μmol/L、9.02±5.46μmol/L、16.73±3.95μmol/L) were obviously lower than before dosage (15.67±4.21μmol/L、15.11±6.24μmol/L、21.78±7.21μmol/L, P<0.05～0.01). There were exceptional brain wave(6/21) and frequent spike wave (1/21)in the EEG of cases.Conclussion The metabolism balance of excitatory and inhibitory amino acid neurotransmitter affected by ciprofloxacin in the central nervous system. The turbulence of metabolism balance can be indicated through the CSF. ......