乌司他丁对急性中型颅脑损伤患者血清IL-6、NSE的影响

Effect of ulinastatin on serum levels of IL-6 and NSE in patients with acute moderate traumatic braininjury

目的观察乌司他丁（Ulinastatin）对急性中型颅脑损伤患者血清IL-6、NSE水平影响，探讨乌司他丁治疗急性中型颅脑损伤的分子生物学机制。方法采用前瞻性随机、对照试验方案，连续纳入急性中型颅脑损伤患者86例，采用随机数字表分为对照组和观察组。对照组采用常规治疗加安慰剂（0．9％氯化钠），观察组在常规治疗基础上加用乌司他丁200000U，2次，d，7d为1个疗程。比较两组患者治疗后第1、3、5、7d血清NSE、IL-6的水平变化。结果治疗后两组患者第1d的血清IL-6水平比较差异无统计学意义（P〉0．05）；治疗后第3、5、7d观察组均显著低于对照组，差异有统计学意义（P〈0．05）；治疗后两组患者第1、3d的血清NSE水平比较差异无统计学意义（P〉0．05），治疗后第5、7d观察组均显著低于对照组，差异有统计学意义（P〈0．05）。结论乌司他丁可抑制急性中型颅脑损伤患者继发的炎性级联反应，减轻病灶周围神经细胞不正当凋亡。

Objective To investigate the effect of ulinastatin on the serum levels of IL-6 and NSE in patients with acute moderate traumatic brain injury and to explore the molecular biological mechanism of ulinastatin in the treatment of acute moderate traumatic brain injury. Methods A prospective randomized controlled trial was conducted. 86 patients with acute moderate traumatic brain injury were randomly divided into control group and observation group. The control group received conventional treatment and placebo （0.9% sodium chloride）, while the observation group was treated with ulinastatin on the basis of conventional treatment, 200 000 U, 2 times / day, 7 days for 1 course. The serum levels of NSE and IL-6 were compared between the two groups on the first, third, fifth, and seventh day after treatment. Results There was no statistically significant difference in the serum level of IL-6 between the two groups on the first day after treatment （P〉0.05）; the serum level of IL-6 of the observation group was lower than that of the control group on the third, fifth, and seventh day after treatment, with statistically significant differences （P〈0.05）. There was no statistically significant difference in the serum level of NSE between the two groups on the first and third day after treatment （P〉0.05）; the serum level of NSE of the observation group was lower than that of the control group on the fifth and seventh day after treatment, with statistically significant differences （P〈0.05）. Conclusion Ulinastatin inhibits the secondary inflammatory cascade reaction in patients with acute moderate traumatic brain injury and reduces the inappropriate aDootosis of nerve cells around the lesion.