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目的：探讨脑瘫肌痉挛形成的机制及选择性脊神经后根切断术（ＳＰＲ）后脊髓中枢的改变。方法：采用丹酰氯－聚酰胺薄膜层析法，测定了２４例痉挛型脑瘫、３１例非神经系统疾病儿童及１２例ＳＰＲ后脑瘫患儿脑脊液中兴奋性、抑制性氨基酸水平。结果：痉挛型脑瘫患儿脑脊液中γ－氨基丁酸低于对照组（Ｐ＜０．００１），谷氨酸、天冬氨酸高于对照组（Ｐ＜０．００１），谷氨酸与患儿增高的肌张力呈等级正相关；ＳＰＲ后，γ－氨基丁酸、丙氨酸、甘氨酸明显升高，且高于正常组（Ｐ＜０．０５），谷氨酸、天冬氨酸明显下降，且谷氨酸低于正常组（Ｐ＜０．０５）。结论：突触前抑制下降、脊神经后根传入纤维侧支出芽、突触再建在脑瘫肌痉挛形成中起了重要的作用；ＳＰＲ后，脑脊液中兴奋性氨基酸下降、抑制性氨基酸上升与肌痉挛的解除有关，抑制性氨基酸能神经元侧支出芽、突触再建可能参与了脊髓中枢新的抑制易化平衡
Objective: To explore the mechanism of cerebral spasm formation and the change of spinal cord center after selective spinal nerve root posterior rhizotomy (SPR). METHODS: The excitatory and inhibitory amino acids in cerebrospinal fluid of 24 children with spastic cerebral palsy, 31 children with non-nervous system diseases and 12 children with cerebral palsy after SPR were measured by dansyl chloride-polyamide thin-film chromatography. Results: γ-aminobutyric acid in cerebrospinal fluid of children with spastic cerebral palsy was lower than that of the control group (P <0.001), glutamate and aspartate were higher than those of the control group (P <0.001) There was a positive correlation between the increased muscle tone and the level of γ-aminobutyric acid, alanine, glycine in SPR group, and higher than that in the normal group (P <0.05). Glutamate and aspartate Significantly decreased, and glutamate was lower than the normal group (P <0.05). Conclusions: The decrease of presynaptic inhibition, the afferent afferent of the dorsal root of the spinal cord, and the remodeling of synapses play an important role in the formation of cerebral spasm. After SPR, the levels of excitatory amino acids, inhibitory amino acids and muscle spasms in cerebrospinal fluid Of the lifting of the inhibitory amino acid neurons lateral buds, synaptic reconstruction may be involved in the spinal cord center of the new inhibition of easy to balance