黄芪注射液对急性重型颅脑损伤患者血清神经元特异性烯醇化酶、髓鞘碱性蛋白和S100蛋白B含量的影响

Effects of astragalus mongholicus injection(黄芪注射液)on concentrations of neuron-specific enolase,myelin basic protein and S100 protein B in cases with acute severe craniocerebral injury

目的:观察复方黄芪注射液对急性重型颅脑损伤患者血清神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)和S100蛋白B(S100B)含量的影响。方法:将196例急性重型颅脑损伤患者随机分成常规治疗组和黄芪治疗组两组。黄芪治疗组在脱水、抗感染、器官功能支持、营养神经、预防并发症等常规治疗基础上加用黄芪注射液治疗。于入院时和治疗后4、7和10 d分别测定患者血清NSE、MBP和S100B浓度;并于入院时及入院1周和2周进行格拉斯哥昏迷评分(GCS),3个月后进行格拉斯哥预后评分(GOS)以观察远期疗效。结果:治疗后黄芪治疗组血清NSE、MBP和S100B均低于常规治疗组,差异均有统计学意义〔(14.62±3.38)μg/L比(21.54±5.68)μg/L,(7.52±1.06)mg/L比(10.21±2.01)mg/L,(0.90±0.28)μg/L比(1.20±0.34)μg/L,P均<0.05〕。黄芪治疗组在入院时GCS评分与常规治疗组比较差异无统计学意义〔(5.7±2.0)分比(5.5±2.8)分,P>0.05〕,但入院1周和2周的GCS及治疗3个月后的GOS均显著高于常规治疗组〔(9.8±2.6)分比(7.2±2.1)分,(10.6±3.0)分比(7.8±2.2)分,(4.8±1.0)分比(3.6±0.8)分,P均<0.05〕。结论:黄芪能降低急性重型颅脑损伤患者血清NSE、MBP和S100B含量,并表现出明显的临床治疗效果。

Objective： To investigate the effects of complex prescription astragalus mongholicus injection（复方黄芪注射液） on the serum concentrations of neuron-specific enolase（NSE）,myelin basic protein（MBP） and S100 protein B（S100B） in cases with acute severe craniocerebral injury.Methods： One hundred and ninety-six patients with acute severe craniocerebral injury were randomly divided into two groups.The treated group was treated with complex prescription astragalus mongholicus injection plus conventional treatments including dehydration,antibiotics,organ functional support,nerve nutrition,prevention of complication,etc;the control group was treated with conventional treatments alone.The concentrations of NSE,MBP and S100B in plasma at admission and at 4,7 and 10 days after treatment were determined;the Glasgow coma score（GCS） at admission and at 1 week and 2 weeks after hospitalization and the Glasgow outcome scale（GOS） after 3 months were compared to observe the long-term efficacy in the patients.Results： After treatment,the concentrations of serum NSE,MBP and S100B in the treatment group were all lower than those in the control group,the differences being significant（NSE（14.62±3.38）μg/L vs.（21.54±5.68） μg/L,MBP（7.52±1.06） mg/L vs.（10.21±2.01） mg/L,S100B（0.90±0.28） μg/L vs.（1.20±0.34） μg/L,all P〈0.05）.Before treatment,the GCSs of patients in the two groups had no statistical difference （（5.7±2.0） score vs.（5.5±2.8） score,P〉0.05）;the GCSs of the patients at 1 week,2 weeks and GOS at 3 months after treatment in the complex prescription astragalus mongholicus injection group were significantly higher than those in the control group（GCS, 1 week（9.8±2.6）score vs.（7.2±2.1） score,2 weeks（10.6±3.0） score vs.（7.8±2.2） score;GOS,3 months after treatment（4.8±1.0） score vs.（3.6±0.8） score,all P〈0.05））.Conclusion： Complex prescription astragalus mongholicus injection can alleviate the plasma concentrations of NSE,MBP and S100B in cases with acute severe craniocerebral injury and markedly improve the clinical therapeutic effects.