依达拉奉对脑复苏患者血清神经元烯醇酶（NSE）的影响

Neueoprotective effects of edaravone on patients with cerebral resuscitation

目的观察依达拉奉对脑复苏患者血清特异性神经元烯醇化酶（NSE）的影响。方法选择心肺复苏（CPR）后恢复自主循环（ROSC）的患者66例，随机分为常规治疗组33例和依达拉奉组33例，常规治疗组给予常规对症支持治疗，依达拉奉组在常规治疗的基础上，加用生理盐水100ml＋依达拉奉（edaravone）30mg静滴，2匆d，疗程14d。两组患者分别在治疗前、治疗后24h、72h、7d、14d静脉采血，采用酶联免疫吸附法（EusA）测血清NSE值，对比两组患者在治疗前后血清NSE的变化规律，并注意观察患者的药物不良反应；结果常规治疗组患者死亡23例，持续植物状态6例，预后不良共29例，预后良好仅有4例；依达拉奉组患者死亡22例，持续植物状态6例，预后不良共28例，预后良好仅有5例，两组患者治疗成功率相比，差异无统计学意义（P〉0．05）。治疗前后两组患者血清NSE值的变化：治疗24h、72h、7d、14d后，与治疗前相比，两组患者中预后良好的患者血清NSE值均随着治疗时间的延长而逐步降低，差异有显著性意义（P〈0．01或P〈0．05），与常规组相比，依达拉奉组降低更加明显，差异有统计学意义（P〈0．01）；预后不良的患者血清NSE值与治疗前相比，差异无统计学意义（P〉0．05），依达拉奉组与常规组相比，血清NSE值无明显变化，差异无统计学意义（P〉0．05）。不良反应的观察：依达拉奉组中预后良好的患者未见明显的肝肾功能减退及粒细胞减少等不良反应。结论心跳呼吸骤停患者大多预后不良；依达拉奉对CPR术后脑复苏患者具有一定的神经保护作用，但并不能改善患者预后；NSE可能可以作为早期判断CPR术后患者脑功能恢复良好的一种生化学指标；脑复苏患者使用依达拉奉具有一定的安全性。

Objective To observe the effects of edaravone on the concentration of serum neuron specific enolase （NSE） of patient with cerebral resuscitation. Methods 66 patients with restoration of spontaneous circulation （ROSC） upon cardiopulmonary resuscitation （CPR） were randomly divided into two groups with 33 in each group, conventional treatment group and edaravone group. On top of the treatment provided to the conventional treatment group, the edaravone group were added NS100ml＋edaravone 30mg injection twice a day, for a total of 14 days, the concentration of serum neuron specific enolase （NSE） were detected by enzyme-linked immunosorbent assay （ELISA） prior to and 24 hours, 72 hours, 7 days, and 14 days after the treatment with comparison on the dynamie changes of the concentration of the serum NSE, and the drug adverse reaction was also observed. Results 1. Of the conventional treatment group, 23 patients died, 6 patients underwent persistent vegetative state （PVS）, resulting in a total of 29 patients undergone a worse prognosis with only 4 patients undergone a better prognosis; of the edaravone group, 22 patients died, 6 patients underwent PVS, resulting in a total of 28 patients undergone a worse prognosis with only 5 patients undergone a better prognosis. There was no statistical difference in therapeutic efficiency between the two groups （P〉 0.05）; 2. The concentration of the serum NSE of the patients showed a better prognosis in both two groups as it went down respectively during the extension of the treatment 24 hours, 72 hours, 7 days, and 14 days after treatment with a statistical difference （P〈 0.01 or P〈0.05）. Comparing with the conventional treatment group, the concentration of the serum NSE even went down more obviously in the edaravone group with a statistical difference （P〈0.01）; the concentration of the serum NSE of patients who had a negative prognosis reflected not much change with no statistical difference （P〉 0.05） before and after the treatment. Comparing with conventional treatment group, concentration of the serum NSE showed no statistical difference （P 〉 0.05） in the edaravone group; 3. There were no obvious dysfunction of liver, renal and granulocytopenia, and other drug adverse reactions in patients who had a better prognosis in edaravone group. Conclusion 1. Most of patients who experienced sudden cardiac arrest （SCA） has a worse prognosis; 2. Even edaravone carries some kind of neueoprotective effects on patients who have cardiopulmonary （CPR） it doesn ＇t improve the patients＇ prognosis. 3. Concentration of the serum NSE may be used as one of the biochemistry parameters to evaluate the function of cerebral on an early stage after CPR is performed; 4. Edaravone is considered to be used on patients who had cerebral resuscitation.