神经节苷酯钠辅助治疗对急性重症颅脑损伤患者神经损伤程度及细胞因子、体液免疫的影响

Effect of adjuvant ganglioside sodium therapy on nerve injury degree as well as cytokines and humoral immunity in patients with acute severe craniocerebral injury

目的:研究神经节苷酯钠辅助治疗对急性重症颅脑损伤患者神经损伤程度及细胞因子、体液免疫的影响。方法:选择2013年3月~2016年3月在我院就诊的94例重型颅脑损伤患者,并随机分为神经节苷脂钠组(GM1组)和对照组,治疗前及治疗后4、8周时分别测定血清中神经损伤分子、神经损伤细胞因子、炎症细胞因子、体液免疫分子的含量。结果:治疗后4、8周时,两组血清中神经元特异性烯醇化酶(NSE)、星形胶质源性蛋白(S100β)、泛素羧基末端水解酶L1(UCH-L1)、胶质纤维酸性蛋白(GFAP)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)的含量均显著低于治疗前,脑源性神经营养因子(BDNF)、神经生长因子(NGF)、免疫球蛋白G(IgG)、IgM、IgA的含量均显著高于治疗前(P<0.05),且GM1组患者血清中NSE、S100β、UCH-L1、GFAP、hs-CRP、TNF-α、IL-6的含量均显著低于对照组,BDNF、NGF、IgG、IgM、IgA的含量均显著高于对照组(P<0.05)。结论:神经节苷酯钠辅助治疗能够减轻急性重症颅脑损伤患者的神经损伤程度,抑制炎症反应并提高体液免疫应答。

Objective： To study the effect of adjuvant ganglioside sodium therapy on nerve injury degree as well as cytokines and humoral immunity in patients with acute severe craniocerebral injury. Methods： A total of 94 patients with severe craniocerebral injury treated in our hospital between March 2013 and March 2016 were selected and randomly divided into the ganglioside sodium group（ GM1 group） and control group. Before treatment as well as after 4 weeks and 8 weeks of treatment,serum levels of nerve injury molecules,nerve injury cytokines,inflammatory cytokines and humoral immune molecules were determined respectively. Results： After 4 weeks and 8 weeks of treatment,serum NSE,S100β,UCH-L1,GFAP,hs-CRP,TNF-α and IL-6 content of both groups were significantly lower than those before treatment while BDNF,NGF,Ig G,Ig M and Ig A content were significantly higher than those before treatment（ P〈0. 05）,and serum NSE,S100β,UCH-L1,GFAP,hs-CRP,TNF-α and IL-6 content of GM1 group were significantly lower than those of control group while BDNF,NGF,IgG,IgM and IgA content were significantly higher than those of control group（ P〈0. 05）. Conclusions： Adjuvant ganglioside sodium therapy can relieve the nerve injury,inhibit the inflammatory reaction and improve the humoral immune response in patients with acute severe craniocerebral injury.