RESUMEN
Levels of brain creatine phosphokinase (CPK), glutamic oxalic transaminase, lactate dehydrogenase, and lactate in lumbar cerebrospinal fluid (CSF) were analyzed as an adjunctive study in a randomized clinical trial evaluating the effects of thiopental loading intravenously in comatose survivors of cardiac arrest. Three hospitals participated and a total of 62 cases of enzyme changes were studied. Enzyme levels but not lactate were higher at 48 hours than at 24 hours after restoration of spontaneous circulation. All enzymes were highly correlated with one another at 24 and 48 hours (P < .001). There was a significant negative correlation between cerebral recovery and increased CPK levels at 24 hours (P < .05), and a highly significant correlation with all three enzyme levels at 48 hours (P < .0001). The increase of cytosolic enzyme activity in lumbar CSF reflects permanent brain damage, and there is a relationship between activity levels and cerebral outcome.
Asunto(s)
Aspartato Aminotransferasas/líquido cefalorraquídeo , Química Encefálica , Coma/tratamiento farmacológico , Creatina Quinasa/líquido cefalorraquídeo , Paro Cardíaco/complicaciones , L-Lactato Deshidrogenasa/líquido cefalorraquídeo , Lactatos/líquido cefalorraquídeo , Tiopental/uso terapéutico , Coma/líquido cefalorraquídeo , Coma/etiología , Humanos , Inyecciones Intravenosas , Ácido Láctico , Pronóstico , Sobrevivientes , Factores de TiempoRESUMEN
Foram avaliadas as atividades enzimáticas da CK, DHL, e AST em 60 amostras normais de LCR e de soro sangüíneo colhidas concomitantemente nos mesmos pacientes. Os valores médios obtidos no LCR foram respectivamente de 5, 19 e 9 U/L para cada uma das enzimas. Do total de 60 casos, 57 (95%) tiveram atividades máximas até 13 U/L para a CK, 40 U/L para DHL e 15 U/L para a AST. Os valores médios da relaçäo LCR/soro das enzimas CK, DHL e AST foram, respectivamente, 0,15,0,10 e 0,90, sugerindo, portanto, a existência de diferenças na permeabilidade da barreira hemato-liquórica para cada uma das três enzimas estudadas