丰富康复训练对脑外伤患者认知功能和血清谷氨酸的影响

Influence of enriched rehabilitation training on cognitive function and serum glutamate in patients with traumatic brain injury

目的探讨丰富康复训练对脑外伤患者认知功能和血清谷氨酸的影响。方法选取30例脑外伤后认知功能障碍患者为观察组,另选取30名正常人群为对照组。对照组不给予任何药物治疗与训练,观察组给予常规药物治疗和丰富康复训练,频率为每天1次,每周6 d,连续8周。比较2组治疗前后蒙特利尔认知评估量表(MoCA)评分、数字符号模式测试(SDMT)评分、连线测试B部分(TMT-B)以及血清谷氨酸、丙二醛、肿瘤坏死因子水平。结果治疗前,观察组MoCA评分、SDMT评分低于对照组,TMT-B高于对照组,差异有统计学意义(P<0.05);治疗后,观察组MoCA评分、SDMT评分、TMT-B较治疗前有所改善,但MoCA评分、SDMT评分仍低于对照组,TMT-B仍高于对照组,差异有统计学意义(P<0.05)。治疗前,观察组血清谷氨酸、丙二醛及肿瘤坏死因子水平高于对照组,差异有统计学意义(P<0.05);治疗后,观察组血清谷氨酸、丙二醛及肿瘤坏死因子水平均较治疗前降低,但仍高于对照组,差异有统计学意义(P<0.05)。结论丰富康复训练能够促进脑外伤患者认知功能的恢复,其作用机制可能与丰富康复训练可有效降低脑外伤后异常升高的血清谷氨酸水平、减轻氧化应激与炎症反应有关。

Objective To explore the influence of enriched rehabilitation training on cognitive function and serum glutamate in patients with traumatic brain injury.Methods Thirty patients with cognitive dysfunction after traumatic brain injury were selected as observation group,and another 30 normal people were selected as control group.The control group was not given any drug treatment and training,while the observation group was given routine drug treatment and enriched rehabilitation training once per day,and 6 days in a week for 8 weeks.Before and after treatment,score of the Montreal Cognitive Assessment(MoCA),score of Symbol Digit Pattern Test(SDMT)and part B of the Trail Making Test(TMT-B)as well as levels of serum glutamate,malondialdehyde and tumor necrosis factor were compared between two groups.Results Before treatment,the MoCA score and SDMT score in the observation group were significantly lower than those in the control group,while the TMT-B was significantly higher than that in the control group(P<0.05);after treatment,the MoCA score,SDMT score and TMT-B in the observation group were significantly improved,but the MoCA score and SDMT score were still significantly lower than those in the control group,and TMT-B was still significantly higher than that in the control group(P<0.05).Before treatment,the levels of serum glutamate,malondialdehyde and tumor necrosis factor in the observation group were significantly higher than those in the control group(P<0.05);after treatment,the levels of serum glutamate,malondialdehyde and tumor necrosis factor in the observation group reduced significantly,but were still significantly higher than those in the control group(P<0.05).Conclusion Enriched rehabilitation training can promote the recovery of cognitive function in patients with traumatic brain injury,and its mechanism may be related to the effective reduction of abnormally elevated serum glutamate level after brain injury,and the alleviation of oxidative stress and inflammatory reaction.