大剂量维生素C和E对急性颅脑外伤患者临床疗效的观察

Observation of clinical curative effect on patients with acute craniocerebral trauma by large doses of vitamin C and E

目的通过观察大剂量维生素C和E对急性颅脑外伤患者血清中神经元特异性烯醇化酶(NSE)的影响,探讨其对急性颅脑损伤的疗效。方法将90例急性颅脑损伤患者随机分为依达拉奉治疗组(30例)、维生素C和E治疗组(30例)和正常治疗组(30例),利用电化学发光法分别测定患者入院时、第3、7天及第14天血清NSE浓度。入院时进行格拉斯哥昏迷分级评分(GCS)并行出院时、3个月后行格拉斯哥预后(GOS)分级。结果依达拉奉治疗组、维生素C和E治疗组与正常治疗组相比,入院时GCS评分各组比较差异无统计学意义(P>0.05),出院时、3个月后的GOS评分均较正常治疗组改善更为明显,差异有统计学意义(P<0.05)。依达拉奉治疗组与维生素C和E治疗组相比,出院时、3个月后的GOS评分差异无统计学意义(P>0.05)。各治疗组之间入院时NSE水平无统计学意义,较健康对照组明显增高,治疗后含量开始降低,第3、7天依达拉奉治疗组与维生素C和E治疗组较正常治疗组下降更为明显(P<0.05);但依达拉奉治疗组与维生素C和E治疗组之间差异无统计学意义(P>0.05)。NSE水平伤后第14天后下降接近正常,各治疗组间无统计学意义。结论大剂量维生素C联合维生素E与依达拉奉一样,可减轻脑损伤,降低血浆NSE浓度,对急性颅脑损伤有保护作用。

Objective To observe the effect of large doses of vitamin C and E on acute craniocerebral trauma patient＇s serum neuron specific enolase（ NSE）, and to explore the effect of acute brain injury. Methods Ninety patients with acute craniocerebral injury were randomly divided into edaravone group（30 cases）, vitamin C and E treatment group（ 30 cases）and normal treatment group（ 30 cases）, serum NSE concentration on admission,3,7 and 14 days were measured by electrochemical luminescence method, Glasgow coma scale（GCS） score was performed on admission, and the Glasgow outcome scale （GOS）scores at discharge from hospital, 3 months after treatment were progressed. Results Compared with edaravone group,vitamin C and E treatment group and normal treatment group, there was no significant difference in admission GCS score among the four groups（P 〉0. 05） ,3 months after treatment the GOS scores were higher than normal treatment group improved more significantly, there were significant difference （ P 〈 0. 05 ）. Compared with edaravone group and vitamin C and E treatment group, there was no significant difference in GOS scores at discharge,3 months after treatment （P 〉 0.05 ）. There was no significant difference in NSE levels between the treatment groups at admission, compared with healthy control group, the treatment groups increased significantly, and decreased after treatment. At the 3,7 days, edaravone group and vitamin C and E treatment group decreased more significantly than in the normal treatment group （P 〈 0. 05 ）;but the differences between the edaravone group and vitamin C and E treatment group was not significant （P 〉0. 05）. The level of NSE after injury 14 days fell close to normal, all treatment groups had no significant difference（P 〉0. 05）. Conclusion Large dose of vitamin C combined with vitamin E can reduce the brain injury, reduce the concentration of plasma NSE,and has a protective effect on acute craniocerebral injury.