加用rhEPO对重型颅脑损伤伴昏迷患者抢救及预后效果的影响

Effect of adding rhEPO on rescue and prognosis of patients with severe craniocerebral injury accompanied coma

目的研究重组人促红细胞生成素(rhEPO)治疗重型颅脑损伤伴昏迷患者的抢救效果。方法选取收治的重型颅脑损伤伴昏迷患者92例,分为对照组和观察组各46例。对照组患者接受常规治疗,同时静脉滴注纳洛酮治疗;在此基础上,观察组患者皮下注射rhEPO。比较2组患者的抢救效果,同时比较治疗前后白介素-10(IL-10)、超敏-C反应蛋白(hs-CRP)、神经元特异性烯醇化酶(NSE)、梗死面积、格拉斯哥昏迷评分(GCS)和格拉斯哥预后评分(GOS)情况。结果观察组的抢救总有效率(80.43%)明显高于对照组(65.21%)(P<0.05);观察组的清醒时间明显低于对照组(P<0.05);治疗后,观察组的血清NSE和hs-CRP水平明显低于对照组(P<0.05),血清IL-10水平和GCS评分明显高于对照组(P<0.05);治疗后6个月观察组的梗死面积明显低于对照组(P<0.05),GOS评分明显高于对照组(P<0.05)。结论 rhEPO抢救重型颅脑损伤伴昏迷患者的效果显著,能够有效抑制IL-10、hs-CRP及NSE表达,促进神经功能恢复及预后,值得在临床推广。

Objective To study the effect of recombinant human erythropoietin （rhEPO） in treatment of severe craniocerebral injury and coma patients. Methods 92 patients with severe head injury with coma patients from October 2015 to January 2017 in our hospital were collected. All the patients were divided into control group and observation group, which have 46 cases in each group. Pa- tients in the control group received conventional treatment and intravenous drip of naloxone was treated. On this basis, the patients in the observation group were injected with rhEPO under the skin. Compare two groups patients of the rescue effect and interleukin 10 （ IL - 10 ）, high sensitive C - reactive protein（ hs - CRP）, neuron specific enolization enzyme（ NSE）, infarction area, lars elder brother coma scale （GCS） and Glasgow outcome score（GOS） before and after treatment. Results The observation group of the total effective rate （ 80.43 % ） was significantly higher than that of the control group （65.21% ） （ X2 = 5.27, P 〈 0.05 ）. The awake time of the observation group was significantly lower than the control group（ P 〈 0.05 ）. Serum IL - 10 level and GCS score were significantly higher than the control group（P 〈 0.05）. After 6 months of treatment, the infarct size of the observation group was significantly lower than the control group （P 〈 0.05 ）. The GOS score was significantly higher than the control group （ P 〈 0.05 ）. Conclusion rhEPO can effectively inhibit the expression of IL - 10, hs - CRP and NSE in patients with severe craniocerebral injury and coma, and promote the recovery and prog- nosis of neurologic function, which is worthy of clinical promotion.