依达拉奉参与脑出血患者脑保护及对血清TNF-α和IL-6水平影响的研究

The protective neuroiogical function of edaravone in acute cerebral hemorrhage and the effect on serum IL-6 and TNF-α

目的观察急性脑出血患者应用依达拉奉治疗对血清IL-6、TNF-α水平的影响以及神经功能缺损评分的变化,以探讨依达拉奉参与脑出血患者神经功能保护的机制。方法选择2013年6月—2014年8月收治的脑出血患者86例作为研究对象,随机分成对照组42例和治疗组44例。对照组给予常规治疗,治疗组在对照组的基础上加用依达拉奉30 mg/次,2次/d,两组均治疗14 d。分别于治疗的第1、7、14天应用ELISA法检测两组患者血清中TNF-α和IL-6水平,同时对患者进行神经功能缺损评分。计量资料组间比较采用t检验,组内比较采用配对t检验,P<0.05为差异有统计学意义。结果治疗第1、7、14天对照组IL-6水平分别为(63.8±11.2)、(49.7±8.2)、(40.5±7.4)ng/L,治疗组分别为(62.3±10.1)、(43.9±6.7)、(28.6±5.3)ng/L,对照组TNF-α水平分别为(41.8±5.9)、(34.2±4.9)、(26.7±4.2)ng/L,治疗组分别为(42.5±6.1)、(28.9±4.3)、(17.5±3.8)ng/L,对照组美国国立卫生研究院脑卒中量表(national institute of health stroke scale,NIHSS)评分分别为(20.5±4.4)、(18.2±3.7)、(16.3±3.4)分,治疗组分别为(20.3±4.5)、(16.5±3.2)、(12.7±2.8)分,两组治疗第7、14天血清IL-6和TNF-α水平及NIHSS评分均明显低于治疗第1天,差异均有统计学意义(均P<0.05)。治疗后各观察指标两组间差异均有统计学意义(均P<0.05)。结论依达拉奉能改善脑出血患者神经功能缺损,降低血清中TNF-α和IL-6的产生,减轻脑出血患者脑组织的炎性反应,起到脑保护作用。

Objective To study the effect of edaravone on serum IL-6,TNF-α and neurologic functional in acute cerebral hem- orrhage,discuss the protective mechanism of edaravone on cerebral hemorrhage.Methods 86 cases of cerebral hemorrhage from June 2013 to August 2014 were randomly divided into control group （42 cases） and treatment group （44 cases）.The control group was given routine treatment and the treatment group was given edaravone 30 mg bid.Each groups were treated 14 days.The serum IL-6 and TNF-α were detected by ELISA before therapy and after treatment for 7 days and 14 days.Neurological function deficit scores were utilized at the same time.Comparison of measurement data between groups using t-test,in group were compared with paired t-test.There were statistically significant differences in P〈0.05.Results The levels of IL-6 after treatment of 1,7,14 days in the control group were （63.8 ± 11.2）,（49.7 ± 8.2）,（40.5±7.4）ng/L,in treatment group were （62.3 ±10.1）,（43.9 ± 6.7）,（28.6 ±5.3） ng/L.The levels of TNF-α in control group were （41.8 ±5.9）,（34.2 ± 4.9）,（26.7 ± 4.2）ng/L,in treatment group were （42.5 ± 6.1）, （28.9 ± 4.3）,（17.5 ±3.8）ng/L.The national institute of health stroke scale （NIHSS） score of control group were （20.5± 4.4）,（18.2 ± 3.7）,（16.3 ± 3.4）point,in treatment group were （20.3 ± 4.5）,（16.5 ± 3.2）,（12.7 ± 2.8）point.After treatment,the serum levels of IL-6, TNF-α and the scale of NIHSS in treatment group were more obviously decreased than that in control group,differences were sta- tistically sifnificant（all P〈0.05）.Conclusion Edaravone could improve neurological deficits in patients with cerebral hemorrhage, reduce serum TNF-α and IL-6 produced,and reduce the inflammatory response in patients＇ brain tissue,play a protective role in the brain.