cerebrospinal fluid calcitonin gene-related peptide

CGRP is a 37-amino acid neuropeptide widely distributed in the central and peripheral nervous systems. It is mainly involved in the cardiovascular system or autonomic nerve endings in the cardiovascular system and is an important transmitter of the central and peripheral nervous system. Its biological activity is to activate the adenylate cyclase to increase the intracellular cAMP by binding to a specific receptor, and to produce a biological effect through the intermediary of the second messenger cAMP. It has strong vasodilation, positive myocardial inotropic and chronotropic effects, participates in the regulation of blood glucose and inhibits lipid peroxidation, and protects various tissue cells. Basic Information Specialist classification: examination classification: cerebrospinal fluid examination Applicable gender: whether men and women apply fasting: fasting Analysis results: Below normal: Found in patients with viral encephalitis. Normal value: Cerebrospinal fluid CGRP: 36-54pg/ml Above normal: Found in hemorrhagic cerebrovascular disease, ischemic cerebrovascular disease. negative: Positive: Tips: The examinee should stop taking the medicine. Normal value 45 ± 9 pg / ml. Clinical significance Abnormal result Increased in hemorrhagic cerebrovascular disease, ischemic cerebrovascular disease. People who need to be tested There are contralateral hemiplegia (heavy lower limbs, light upper limbs), strong grip reflexes, urinary incontinence, emotional apathy, confusion, paralytic paraplegia and other symptoms, especially the elderly. High results may be diseases: precautions for insufficient blood supply to the vertebral basilar artery in the elderly Before testing: The examinee should suspend taking the drug. When checking: Relax your body and eliminate anxiety and tension. Inspection process 1. The patient lies on the hard board bed, the back is perpendicular to the table top, the head is bent as far as possible to the chest, the knees are tightly attached to the abdomen with both hands, so that the trunk is as arched as possible; or the assistant is used to hold the patient's head opposite the surgeon. The other hand pulls the lower limbs of the armpits and holds them tightly, so that the spine is as convex as possible to widen the intervertebral space, which is convenient for needle insertion. 2, determine the puncture point, usually the junction point of the highest point of the bilateral iliac spine and the posterior median line as the puncture point, here is equivalent to the third to fourth lumbar spine process, sometimes in the upper or lower lumbar spine The gap is carried out. 3, routine disinfection of the skin after wearing sterile gloves, cover the hole towel, with 2% lidocaine from the skin to the interspinous ligament for layer-by-layer local anesthesia. 4, the surgeon uses the left hand to fix the puncture point skin, the right hand holding puncture needle to the vertical back, the needle tip slightly obliquely to the direction of the head, the adult needle depth is about 4 ~ 6cm, children about 2 ~ 4cm. When the needle passes through the ligament and the dura mater, there is a sudden loss of resistance. At this point, the needle core can be slowly withdrawn (to prevent the cerebrospinal fluid from flowing out quickly, causing cerebral palsy), and the cerebrospinal fluid can be seen to flow out. 5. Connect the pressure measuring tube to measure the pressure before draining. The cerebrospinal fluid pressure in the normal lateral position is 70-180 mmH2O (0.098 Kpa=10 mmH2O) or 40-50 d/min. If you continue to do the queckstedt test, you can see if there is any obstruction in the subarachnoid space. That is, after the initial pressure is measured, the assistant first compresses one side of the carotid artery for about 10 s, then presses the other side, and finally presses both sides of the carotid artery. When the carotid artery is compressed at normal time, the pressure of the cerebrospinal fluid immediately increases by about one time, and after 10 to 20 seconds after the pressure is released, it rapidly drops to the original level, which is called negative in the obstruction test, indicating that the subarachnoid space is unobstructed; if the carotid artery is compressed, it cannot be When the pressure of the cerebrospinal fluid is raised, the obstruction test is positive, indicating that the subarachnoid space is completely blocked. If it rises slowly after applying pressure, it will slowly fall after relaxation, indicating incomplete obstruction. but. Those with increased intracranial pressure are forbidden to do this test. 6. Remove the pressure measuring tube and collect 2~5ml of cerebrospinal fluid for examination. If it is needed for cultivation, use sterile tube to keep the specimen. 7. After the operation, insert the needle core and pull out the puncture needle together, cover the sterile gauze, and fix it with tape. 8, go to the pillow for 4 to 6 hours, so as not to cause postoperative low intracranial pressure headache. Not suitable for the crowd 1. If there is obvious papilledema or cerebral palsy, contraindications are contraindicated. 2. Patients who are in shock, exhaustion or endangered state and local skin inflammation, and lesions in the posterior cranial fossa are contraindicated. Adverse reactions and risks If the patient has symptoms such as breathing, pulse, or abnormal color during puncture, stop the operation immediately and deal with it accordingly.

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