联合应用甘露醇、单唾液酸神经节苷脂对脑出血致脑水肿的临床疗效及对神经功能的影响

Efficacy of combined application of mannitol and monosialoganglioside on neurological function and its efficacy in brain edema afterintracerebral hemorrhage

目的 探讨联合应用甘露醇、神经节苷脂对脑出血致脑水肿后神经功能的影响。方法 选取脑出血脑水肿患者92例,按随机数字表法分为组,各46例,对照组在基础治疗上予以甘露醇（125m L/次,1次/8h）治疗,研究组在基础治疗上予以单唾液酸神经节苷脂（20mg/次,1次/天）辅助甘露醇治疗,治疗10d为一疗程,测定血清学指标,记录神经功能变化状况。结果 对照组总有效率71.74%低于研究组的91.30%（P〈0.05）;相对于对照组,研究组治疗后颅内压、血肿、水肿较低,尿量较高,神经功能缺损评分（national institutes of health stroke scale,NIHSS）评分和生活质量评分较低,血清白细胞介素1β（interleukin,IL-1β）、超敏C反应蛋白（high sensitive C reaction protein,Hs-CRP）、IL-6及IL-8水平较低,Na＋-K＋-ATP酶较高,脑脊液白蛋白/血清白蛋白比值、基质金属蛋白酶（matrix metalloproteinase,MMP-2）和MMP-9较低（P〈0.05）。结论 联合应用甘露醇、神经节苷脂对脑出血致脑水肿后神经功能疗效确切,提高神经功能。

Objective To investigate the effect of combined application of mannitol and monosialoganglioside on neurological function and its efficacy in brain edema afteT intracerebral hemorrhage. Methods 92 cases o f cerebral edema in patients with cerebral hemorrhage in our hospital, were randomly divided into groups, each group of 46 cases, the control group on the basis of the treatment of mannitol （125mL per times, once per 8h） treatment, the study group on the basic of control group received monosialogangliosides （20mg per times, once daily）, lOd for a course of treatment, determination of serum indexes, neurological functions were recorded. Results The effective rate o f control group was 71.74%, which was lower than 91.30% of the study group, there was significant difference （P 〈 0.05）; compared with control group after treatment, in study group the intracranial pressure, intracranial hematoma, edema decreased, the urine volume increased, National Institutes of Health Stroke Scale （NIHSS） and quality of life score decreased, interleukin （IL-lp）, high sensitive C reaction protein （Hs-CRP）, IL-6 and IL-8 levels decreased, Na＋-K＋-ATP enzyme increase^ the ratio of cerebrospinal fluid albumin and serum albumin, matrix metalloproteinase （MMP-2） and MMP-9 decreased, there were significant differences （P 〈 0.05）. Conclusion The effect of the combined application of mannitol and monosialoganglioside on cerebral edema after cerebral hemorrhage is exact and could improve neurologic function.