胸腺肽α1和乌司他丁联用促进急性颅脑损伤患者恢复的临床研究

Clinical study of thymosin α1 combined with ulinastatin on promoting the recovery of patients with acute craniocerebral injury

目的:分析胸腺肽α1和乌司他丁联用促进急性颅脑损伤患者恢复的效果。方法:90例急性颅脑损伤患者随机分为观察组及对照组,对照组接受神经外科常规治疗,观察组接受常规治疗+胸腺肽α1+乌司他丁治疗,对比两组治疗后脑血流参数及颅内压、血清及脑脊液脑损伤指标水平差异。结果:观察组治疗后1、3d,颞部大脑中动脉(MCA)Vs、Vm值高于对照组,颅内压(ICP)值低于对照组(P<0.05);观察组治疗后3d血清神经胶质纤维酸性蛋白(GFAP)、泛素羧基端水解酶(UCH-L1)、抗脑抗体(ABAB)、皮质醇(Cor)水平及胰岛素抵抗指数(HOMA-IR)值低于对照组,脑脊液肌酸磷酸激酶(CPK)、乳酸脱氢酶(LDH)、谷草转氨酶(GOT)、亮氨酸氨基肽酶(LAP)水平低于对照组(P<0.05)。结论:胸腺肽α1和乌司他丁是治疗急性颅脑损伤的可靠方法,在降低脑损伤、恢复脑血流等方面均有肯定作用。

Objective： To analyze the effect of thymosin al combined with ulinastatin on promoting the recovery of pa- tients with acute craniocerebral injury. Methods： Ninety cases of patients with acute cranioeerebral injury were randomly divided into observation group and control group; control group received routine neurosurgical therapy, while observation group re- ceived conventional treatment ＋ thymosin α1 ＋ ulinastatin treatment; differences in cerebral blood flow parameters and in- tracranial pressure, levels of cerebral injury indexes in serum and cerebrospinal fluid, etc. were compared between two groups after treatment. Results： Middle cerebral artery （MCA） Vs and Vm values of observation group 1 d and 3 d after treatment were significantly higher than those of control group, and intracranial pressure （ICP） values were significantly lower than those of control group （P〈0.05）; serum glial fibrillary acidic portein （GFAP）, ubiquitin carboxy-terminal hydrolase L1 （UCH- L1）, anti-brain tissue antibody （ABAB） and cortisol （Cor） levels as well as homeostasis model assessment of insulin resistance （HOMA-IR） value of observation group 3 d after treatment were significantly lower than those of control group, and creatine phosphate kinase （CPK）, lactate dehydrogenase （LDH）, glutamic-oxaloacetic transaminase （GOT） and leucine aminopeptid- ase （LAP） levels in cerebrospinal fluid were significantly lower than those of control group （P〈0.05）. Conclusions： Thymosin α1 with ulinastatin is a reliable method in treatment of acute craniocerebral injury, and has positive effect on reducing cerebralinjury, restoring cerebral blood flow and other aspects.