盐酸纳美芬联合依达拉奉对原发性脑干损伤患者神经功能重建、氧化应激及炎症因子的影响

EFFECTS OF NALMEFENE HYDROCHLORIDE COMBINED WITH EDARAVONE ON NEURAL FUNCTION RECONSTRUCTION OXIDATIVE STRESS AND INFLAMMATORY FACTORS IN PATIENTS WITH PRIMARY BRAIN STEM INJURY

目的观察盐酸纳美芬联合依达拉奉对原发性脑干损伤患者神经功能重建、氧化应激及炎症因子的影响。方法回顾性分析2018年2月—2021年1月来华北理工大学附属医院就诊的原发性脑干损伤患者的病例资料,将入选的60例患者按照治疗方法分成二组:对照组(n=30,给予常规综合治疗,包括吸氧、抗休克及抗感染、纠正水及电解质平衡等);观察组(n=30,在对照组的基础上加用盐酸纳美芬联合依达拉奉静脉滴注治疗);二组治疗时间均为两周。分析二组患者人口学特征、神经功能重建相关指标(BDNF、NGF、IGF-1),氧化应激相关指标(SOD、TAOC、MDA),炎症因子(TNF-α、hs-CRP、IL-8)水平。结果二组患者在性别、年龄、GCS评分及致伤原因等基线资料差异无统计学意义(P>0.05)。治疗后二组血清及观察组脑脊液BDNF、NGF、IGF-1水平均增加且观察组血清BDNF、NGF、IGF-1水平显著高于对照组(P<0.05);治疗后二组血清及观察组脑脊液TAOC、SOD水平均显著上升,MDA水平均显著下降且观察组血清SOD水平显著高于对照组,而MDA水平显著低于对照组(P<0.05);治疗后二组血清及观察组脑脊液hs-CRP、TNF-α、IL-8水平与治疗前相比均显著下降,且观察组血清hs-CRP、TNF-α、IL-8水平显著低于对照组(P<0.05)。结论盐酸纳美芬联合依达拉奉可以抑制原发性脑干损伤患者炎症反应以及调节氧化应激反应,促进患者神经功能重建。

Objective To observe the effects of nalmefene hydrochloride combined with edaravone onneurological function reconstruction,oxidative stress and inflammatory factors in patients with primary brain stem injury.Methods Patients with primary brain stem injury who came to the Affiliated Hospital of North China University of Science and Technology from February 2018 to January 2021 were randomly divided into two groups,Control group(n=30)conventional comprehensive treatment,including oxygen inhalation,anti-shock and anti-infection,correction of water and electrolyte balance;Observation group(n=30)Namefene hydrochloride combined with edaravone intravenous infusion was added on the basis of control group,and the treatment duration of both groups were two weeks.Demographic characteristics and related indexes of neural function reconstruction were observed in 2 groups:BDNF,NGF and IGF-1;Oxidative stress related indexes:SOD,TAOC,MDA;Inflammatory factors:TNF-α,hs-CRP,IL-8.Results There were no significant differences between the two groups in gender,age,GCS score and the cause of injury.After treatment,the levels of BDNF,NGF and IGF-1 in 2 groups were increased,and observation group was significantly higher than control group(P<0.05);After treatment,the levels of TAOC and SOD in 2 groups were significantly increased,while the level of MDA was significantly decreased,and the SOD level in observation group was significantly higher than that in control group,while the MDA level was significantly lower than that in control group(P<0.05).The levels of hs-CRP,TNF-αand IL-8 were significantly decreased compared with before treatment,and the observation group was significantly lower than the control group(P<0.05).Conclusion Namefene hydrochloride combined with edaravone can inhibit the inflammatory response and regulate the oxidative stress response in patients with primary brain stem injury and promote the reconstruction of neurological function.