依达拉奉联合脑苷肌肽对急诊重症颅脑损伤患者氧化应激及神经因子水平的影响

Effect of edaravone combined with cattle encephalon glycoside and ignotin on oxidative stress and nerve factor level in patients with severe craniocerebral injury in emergency department

目的探讨依达拉奉联合脑苷肌肽对急诊重症颅脑损伤患者氧化应激及神经因子水平的影响。方法60例急诊重症颅脑损伤患者根据治疗方法均分为对照组和观察组,对照组采用脑苷肌肽注射液治疗,观察组在对照组治疗的基础上给予依达拉奉注射液治疗,2组均治疗1周;比较2组患者治疗前及治疗1周时检测血清氧化应激指标髓过氧化物酶(MPO)、超氧化物歧化酶(SOD)及丙二醛(MDA)水平,检测血清神经因子S100β蛋白、β-内咖肽(β-EP)、神经特异烯醇化酶(NSE)水平,同时进行日常生活活动(ADL)评分、格拉斯哥昏迷(GCS)及急性生理学及慢性健康状况Ⅱ(APACHEⅡ)评分。结果治疗1周时,2组患者血清MPO、SOD水平及ADL评分、GCS评分均较治疗前升高,且观察组高于对照组(P<0.05);血清MDA、S100β蛋白、β-EP、NSE水平及APACHEⅡ评分均较治疗前降低,且观察组低于对照组(P<0.05);治疗期间,观察组和对照组总不良反应发生率比较差异差异无统计学意义(P>0.05)。结论依达拉奉联合脑苷肌肽对急诊重症颅脑损伤的疗效优于单一脑苷肌肽,其机制可能与减轻患者机体氧化应激反应和神经损伤有关。

Objective To investigate the effects of edaravone combined with cattle encephalon glycoside and ignotin(CEGI)on oxidative stress and nerve factor level in patients with severe craniocerebral injury in emergency department.Methods Sixty patients with severe head injury in emergency department were divided into control and observation groups according to the treatment approach.Control group was given with CEGI,while observation group was treated with CEGI plus edaravone.Both groups were treated for 1 week.Serum oxidative stress indicators including myeloperoxidase(MPO),superoxide dismutase(SOD),and malondialdehyde(MDA)levels were compared between the two groups before treatment and at 1 week of the treatment.The levels of serum n S100β,β-endogypeptide(β-EP)and neurospecific enolase(NSE)were detected.Simultaneously,activities of daily living(ADL),Glasgow coma(GCS),and acute physiology and chronic healthⅡ(APACHEⅡ)were scored.Results At 1 week of the treatment,the levels of serum MPO and SOD,ADL scores,and GCS scores of the two groups were higher than before the treatment,and they were greater in observation group than in control group(P<0.05).Serum MDA,S100β,β-EP,NSE level,and APACHEⅡscore were lower than before treatment,and they were less in observation group than in control group(P<0.05).During the treatment,the difference in the incidence of total adverse reactions between observation and control groups was not statistically significant(P>0.05).Conclusion The efficacy of edaravone combined with CEGI is better than CEGI alone.The mechanism may be related to the reduction of oxidative stress and nerve damage in patients.