早期应用尼莫地平对重度颅脑损伤患者血钠、血钾、血糖、C反应蛋白的影响及预防大面积脑梗塞的作用

Influence of early application of nimodipine on sodium,potassium,glucose,C-reactive protein levels and for prevention of massive cerebral infarction in patients with severe brain injury

目的:探讨早期应用尼莫地平对降低重度颅脑损伤患者血钠、血钾、血糖、C反应蛋白的影响及预防大面积脑梗塞的疗效。方法:选取本院收诊的重度颅脑损伤患者随机分成两组,对照组和观察组各110例,纳入同期健康志愿者30例作为正常健康对照组。对照组采用基础治疗,观察组则在基础治疗的前提下入院后立即静脉注射尼莫地平。比较大面积梗塞组、未发生大面积梗塞组和正常健康对照组血钠、血钾、血糖、C反应蛋白水平,及治疗前后两组间血钠、血钾、血糖、C反应蛋白;比较两组间GOS评分差异及出现大面积脑梗塞的例数及发病情况。结果:大面积梗塞组血钠、血钾、血糖、C反应蛋白水平高于未发生大面积梗塞组和正常健康对照组,差异具有统计学意义(P<0.05)。入院后7d,观察组血钠、血钾、血糖、C反应蛋白水平均低于对照组,差异具有统计学意义(P<0.05)。入院后7、14d观察组GCS评分低于对照组;观察组大面积脑梗塞的发生率低于对照组,差异具有统计学意义(P<0.05)。结论:早期应用尼莫地平对重度颅脑损伤能有效下调患者血钠、血钾、血糖、C反应蛋白水平,降低大面积脑梗塞的发生率。

Objective. To investigate the influence of early application of nimodipine on the sodi- um, potassium, glucose, C-reactive protein levels and for prevention of massive cerebral infarction in pa- tients with severe brain injury. Methods：Patients with severe brain injury were randomly divided into con- trol group（n = 110, routine treatment group）cases and observation group（n = 110, early application of ni- modipine group）which were treated with conventional basic therapy, and conventional basic therapy ＋ ni- modipine. Another 30 healthy volunteers were also enrolled as healthy control group. Then the sodium, potassium, glucose, C-reactive protein levels in patients with massive cerebral infarction, non-massive cer- ebral infarction and healthy control subjects were compared. The GOS score and the incidence cerebral in- farction and morbidity of two groups were investigated. Results,The levels of sodium, potassium, glucose, C-reactive protein in patients with massive cerebral infarction were all higher than those indexes of patients with non-massive cerebral infarction and healthy control subjects. Seven days after admission, so- dium, potassium, glucose, C-reactive protein levels of the observation group were lower than that of the control group. GCS of the observation group on the 7th day and 14th day were lower than that of the con- trol group, and incidence of massive cerebral infarction of the observation group was significant lower than that of the control group （P〈0.05）. Conclusion. Early application of nimodipine could effectively decrease levels of sodium, potassium, glucose, C-reactive protein in patients with severe brain injury and reduce re- duce the incidence of massive cerebral infarction.