促红细胞生成素对急性创伤性颅脑损伤的疗效观察

Therapeutic effects of erythropoietin on functional outcomes following acute traumatic brain injury analysis of 56 cases

目的探讨促红细胞生成素（EPO）对急性创伤性颅脑损伤的临床疗效。方法选择急性颅脑损伤中格拉斯哥昏迷评分（cos）6。12分的患者56名，随机均分为促红素组[给予重组人促红细胞生成素（rhEPO）100IU／Kg，静推，1次／隔日，疗程两周和对照组（给予等体积生理盐水）。观察患者意识觉醒时间，治疗前及治疗1月分别用许淑莲设计的《临床记忆量表》进行记忆商测定以及格拉斯哥昏迷（GSC）评分、格拉斯哥结果评分（GOS）。结果促红素组的意识觉醒时间为（6．86±1．14）d，显著短于盐水组[（8．22±2．35）d，P〈O．05）]。伤后1个月促红素组患者的GCS评分为（10．58±2．29），GOS评分为（4．68±1．13），均显著高于对照组分别为[（9．22±3．34）和（4．11±0．86），均P〈0．05]。促红素组的记忆商阳性率为57．1％，显著低于对照组（71．4％，P〈0．05）。结论EPO可明显改善急性创伤性脑损伤患者的脑功能和临床表现。

Objective To investigate the therapeutic effects of erythropoietin （EPO） on the functional outcomes following acute traumatic brain injury （TBI）. Methods Fifty-six acute TBI patients with the Glasgow coma scale （GCS） scores 6 -12 were randomly divided into 2 equal groups： EPO group, receiving, in addition to hemostasis, dehydration, acid inhibition, and anti-inflammation, recombinant human erytbropoietin （rhEPO） 100 IU/kg iv. Qod for 2 weeks, and control group given normal saline of the same volume instead of rhEPO. The consciousness recovery time was observed. Before and 1 month after the treatment the Clinical Memory Scale developed by Xu Shulian et al. was used to assess the memory quotient （MQ）, and Glasgow Coma Score （GCS） and Glasgow Outcome Score （GOS） were measured. Results The consciousness recovery time of the EPO group was （6.86 ±1.14）d, significantly shorter than that of the control group [（8.22 ±2.35） d, P 〈0.05]. One month after the treatment, the GCS and GOS of the EPO group were （10.58 ±2.29）and （4.68 ± 1.13） respectively, both significantly higher than those of the control group [（9.22±3.34）and（4.11 ±0.86） respectively, both P 〈0.05]. The MQ positive rate of the EPO group was 57.1%, significantly lower than that of the control group （71.4%, P 〈0.05）. Conclusion Posttraumatic administration of EPO significantly improves the long-term functional outcomes after TBI.