依达拉奉联合神经生长因子治疗重型颅脑损伤的疗效分析

Effect of edaravone combined with nerve growth factor on patients with severe craniocerebral injury

目的探讨依达拉奉联合神经生长因子治疗重型颅脑损伤的疗效。方法 2014年1月至2016年6月收治符合标准的重型颅脑损伤90例,根据治疗方法分为对照组和观察组,各45例。对照组给予常规治疗,观察组在对照组的基础上加用依达拉奉联合神经生长因子;疗程2周。治疗前、治疗后2周采用酶联免疫吸附法测定血清髓鞘碱性蛋白(MBP)、神经元特异性烯醇化酶(NSE)、S100β、白细胞介素-6(IL-6)和超敏C反应蛋白(CRP)水平;采用Image-Pro Plus软件计算CT影像脑水肿面积;治疗后3个月采用GOS评分评估预后。结果治疗后2周,两组血清IL-6、S100β、MBP、NSE和hs-CRP水平均明显下降(P<0.05),但观察组下降幅度更明显(P<0.05)。治疗后2周,两组脑水肿面积和APACHE-Ⅱ评分均明显下降(P<0.05),GCS评分明显上升(P<0.05),观察组的变化幅度更明显(P<0.05)。治疗后3个月,观察组预后良好率(64.44%,29/45;GOS评分4~5分)明显高于对照组(46.67,1/45;P<0.05)。结论依达拉奉联合鼠神经生长因子可以保护重症颅脑损伤患者的神经功能因子,降低脑水肿面积,缓解炎症,促进患者意识恢复。

Objective To study the effects of edaravone combined with nerve growth factor on the patients with severe craniocerebral injury(sCCI).Methods The clinical data of 90 patients with sCCI,of whom 45 were treated routinely(control group)and 45 were treated by edaravone combined with nerve growth factor on the basis of routine treatment(observed group)in our hospital from January,2014 to June,2016,were analyzed retrospectively.The serum levels of myelin basic protein(MBP),neuron-specific enolase(NSE),S100β,interleukin-6(IL-6),and supersensitive C-reactive protein(CRP)were determined by enzyme-linked immunosorbent assay,and the cerebral edema area were calculated by Image-Pro Plus software before and 2 weeks after the treatment.The prognoses were evaluated 3 months after the treatment in all the patients.Results The levels of IL-6,S100β,MBP,NSE,and supersensitive CRP were significantly lower 2 weeks after the treatment than those before the treatment in the two groups(P<0.05).The cerebral edema area and APACHE-Ⅱscores were significantly decreased and the GCS score was significantly increased after the treatment compared to those before the treatment in both the groups(P<0.05).The decreases in the cerebral edema area and APACHE-II scores were significantly more in the treatment group than those in the control group 2 weeks after the treatments(P<0.05).The rate of good prognosis(64.44%,29/45)was significantly higher in the treatment group than that(46.67%,21/45)in the control group(P<0.05).Conclusion It is suggested that edaravone combined with nerve growth factor can protect the neurological function in patients with sCCI,the cerebral edema and inflammation reaction and promote the recovery of consciousness in the patients with sCCI.