脑苷肌肽联合亚低温治疗经Fas/FasL信号通路对创伤性颅脑损伤患者神经细胞凋亡的影响

The influence of the therapy of cattle encephalon glycoside and ignotin combined with mild hypothermia to the apoptosis of neurocytes from traumatic brain injury patients via Fas/FasL signal pathway

目的 探究脑苷肌肽联合亚低温的治疗方法对创伤性颅脑损伤患者神经细胞Fas/FasL信号通路以及细胞凋亡的影响.方法 回顾性收集分析90例创伤性颅脑损伤患者病例,根据治疗方案将患者分为亚低温组和亚低温联合脑苷肌肽组.两组患者均采取降颅内压、抗感染、保护脑细胞、解痉挛等常规治疗措施.收集两组患者入院时、治疗1 d、治疗3 d、治疗7 d、治疗14 d的脑脊液样本,通过ELISA法分析患者脑脊液中TNF-α、Fas、FasL、Caspase9蛋白的含量.比较患者GCS评分差异及住院时间差异.结果 脑苷肌肽联合亚低温治疗组患者在接受治疗后不同时间点(治疗3 d、7 d、14 d)TNF-α、Fas、FasL、Caspase9蛋白相比对照组均显著降低.同时,脑苷肌肽联合亚低温治疗组患者GCS评分、住院时间相比对照组患者显著改善.结论 对于创伤性颅脑损伤患者,脑苷肌肽联合亚低温的治疗方案可以经Fas/FasL凋亡信号通路更好地抑制细胞凋亡的发生,并获得更好的临床效果.

Objective To investigate the effects of the therapy of cattle encephalon glycoside and ignotin combined with mild hypothermia to the apoptosis of neurocytes from traumatic brain injury(TBI)patients via Fas/FasL signal pathway.Methods 90 TBI patients were divided into 2 groups:control group(n=45)undergoing conventional treatment including reduction of intracranial pressure,anti-infection,and reduction of spasmolysis and mild hypothermia therapy etc,and experimental group(n=45)receiving injection of cattle encephalon glycoside and ignotin combined with mild hypothermia in addition to the above mentioned treatment.Patients’cerebrospinal fluid samples were collected at the time point of arriving at hospital,1 d,3 d,7 d and 14 d after patients receiving therapy.And the samples were analyzed to investigate the protein concentration changes of TNF-α,Fas,FasL,Caspase9 via ELISA.GCS scoring and hospitalization were also analyzed between two groups.Results Comparing with the samples from control group,the protein concentration of TNF-α,Fas,FasL,Caspase9 from experimental group patients were lower at the time point of 3 d,7 d,14 d after patients’receiving therapy,with statistical differences.And GCS scoring and hospitalization were statistically significantly changed between two groups,which the experimental group show better results.Conclusion The therapy of cattle encephalon glycoside and ignotin combined with mild hypothermia can inhibit the apoptosis of neurocytes to TBI patients via Fas/FasL signal pathway and also can obtain better clinical ends.