醒脑静注射液对弥漫性轴索损伤患者脑内N-乙酰天冬氨酸及胆碱代谢的影响

Effect of Xingnaojing injection on N-acetyl aspartate and choline metabolism in brain of patients with diffuse axonal injury

目的观察醒脑静注射液对弥漫性轴索损伤(diffuse axonal injury,DAI)患者N-乙酰天冬氨酸(N-acetyl aspartate,NAA)及胆碱(choline,Cho)代谢的影响。方法将收治的40例中重度DAI患者按随机数字表分为对照组(20例)、醒脑静治疗组(20例)。对照组给予常规治疗,治疗组在常规治疗的基础上用20 m L/d醒脑静注射液治疗,疗程30 d。分别于伤后24 h,治疗后15、30 d进行GCS评分及用氢质子MR波谱成像(1H-MRS)对脑内NAA/Cr、Cho/Cr进行定量分析。结果醒脑静治疗组在15、30 d时GCS评分高于对照组,与对照组相比,治疗组脑内NAA/Cr含量升高而Cho/Cr含量降低(P<0.05,P<0.01)。结论醒脑静注射液可能通过影响脑内化合物NAA、Cho的代谢,改善DAI患者神经功能缺损症状,具有脑保护作用。

Obiective To observe the effect of Xingnaojing injection （ a traditional Chinese medicine injection） on N-acetyl aspartate （NAA） and choline （Cho） metabolism in the brains of patients with diffuse axonal injury （DAI）. Methods Forty patients with moderate/severe DAI were randomly divided into a control group （ n = 20） and a treatment group （ n = 20）. The control group received conventional treatment, while the treatment group had 20 mL/d of Xingnaojing injection for 30 d in addition. Glasgow coma scale （GCS） scores and hydrogen proton magnetic resonance spectroscopy （1H-MRS） were employed for quantitative analysis of brain NAA/creatine （Cr） and Cho/Cr at 24 h after injury and on the 15th and 30th days after treatment. Results The GCS scores of the treatment group were higher than those of the control group on the 15th and 30th days after treatment. Compared with the control group, the treatment group showed higher NAA/Cr and lower Cho/Cr （P 〈 0. 05, P 〈 0. 01 ）. Gonclusion Xingnaojing injection can alleviate neurologic impairment of the patients with DAI through affecting NAA and Cho metabolism in the brain, and has brain Drotectiw function.