摘要
目的探讨高渗氯化钠羟乙基40淀粉注射液(HSH40)对急性颅脑损伤患者细胞因子及神经功能预后的影响。方法选取2014—2016年赣南医学院第一附属医院收治的急性颅脑损伤患者80例,其中轻型颅脑损伤19例,中型颅脑损伤45例,重型颅脑损伤16例。采用随机数字表法将其分为林格液组(LR组)和HSH40组,每组各40例。LR组和HSH40组分别采用林格液和HSH40复苏7 d,测定输液即刻、输液后1、3、7 d各组S100B蛋白、神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)表达情况,并在6个月后行神经功能预后测定。结果轻型颅脑损伤患者:HSH40组输液后1、3、7 d S100B蛋白、MBP表达水平低于LR组,HSH40组输液后7 d NSE表达水平低于LR组(P<0.05)。中型颅脑损伤患者:HSH40组输液后7 d S100B蛋白、NSE表达水平低于LR组,HSH40组输液后1、3、7 d MBP表达水平低于LR组(P<0.05)。重型颅脑损伤患者:HSH40组输液后1、3、7 d S100B蛋白、MBP表达水平低于LR组,HSH40组输液后7 d NSE表达水平低于LR组(P<0.05)。HSH40组神经功能预后优于LR组(χ~2=15.320,P=0.003)。结论 HSH40能够提高急性颅脑损伤患者神经功能预后,可能与降低S100B蛋白、NSE和MBP细胞因子表达有关。
Objective To investigate the effects of hypertonic saline hydroxyethyl starch 40( HSH40) on the expressions of cytokines and nerve functions in patients with acute traumatic brain injury. Methods We enrolled 80 cases of acute traumatic brain injury from the First Affiliated Hospital of Gannan Medical University,including 19 mild traumatic brain injury cases,45 moderate injury cases,and 16 severe injury cases. They were equally randomized into Ringer's solution( LR)group receiving 7-day Ringer's solution resuscitation and HSH40 group receiving 7-day HSH40 resuscitation. Blood samples were obtained for determination of serum levels of S100 B protein,neuron specific enolase( NSE),myelin basic protein( MBP)at the following time points: at administration,1 day,3 days and 7 days after administration. The neurological prognosis was measured at 6 months. Results Among patients with mild and severe traumatic brain injury,compared with those receiving Ringer's solution resuscitation,those receiving HSH40 resuscitation had lower serum levels of S100 B protein and MBP at 1 d,3 d,7 d after administration and lower serum NSE level at 7 d after administration( P < 0. 05). Among those with moderate traumatic brain injury,compared with those receiving Ringer' s solution resuscitation,those receiving HSH40 resuscitation had much lower serum levels of S100 B protein and NSE at 7 d after treatment,and much lower serum levels of MBP at 1 d,3 d,7 d after treatment( P < 0. 05). HSH40 group showed better nerve function improvement than LR group at 6 months after treatment( χ~2= 15. 320,P = 0. 003). Conclusion HSH40 can improve the neurological prognosis in patients with acute traumatic brain injury,which may be related with the reduction of the expressions of S100 B protein,NSE and MBP.
出处
《中国全科医学》
CAS
北大核心
2017年第35期4362-4366,共5页
Chinese General Practice
基金
江西省科技厅支撑计划(20151BBG70138)
