乌司他丁联合依达拉奉治疗重症颅脑损伤患者的临床疗效及对神经功能的影响

Clinical efficacy of ulinastatin combined with edaravone in the treatment of patients with severe craniocerebral injury and its effect on neurological function

目的观察乌司他丁联合依达拉奉治疗重症颅脑损伤患者的临床疗效及对神经功能的影响。方法将98例重症颅脑损伤患者随机分为对照组和试验组各49例。2组均给予相同的常规治疗,在此基础上,对照组将注射用依达拉奉30 mL溶于生理盐水100 mL,静脉滴注,每日2次。试验组在对照组的基础上给予乌司他丁注射液4 mL溶于生理盐水100 mL,静脉滴注,每日2次,2组均治疗2周。比较2组治疗前后氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)]、神经功能指标[神经元特异性烯醇化酶(NSE)、N端脑钠肽前体(NT-pro-BNP)]、脑血流灌注情况[脑血流量(CBF)、脑血容量(CBV)],以及临床疗效和药物不良反应发生情况。结果试验组治疗有效率为95.92%,高于对照组的83.67%,2组比较差异无统计学意义(P>0.05)。治疗后,试验组和对照组MDA分别为(6.01±1.58),(8.04±2.20)nmol·L^(-1);SOD分别为(103.02±12.54),(90.66±10.68)kU·L^(-1);NSE分别为(11.40±2.37),(15.85±2.78)ng·L^(-1);NT-pro-BNP分别为(100.57±12.69),(90.85±10.94)pg·mL^(-1),差异均有统计学意义(均P<0.05)。2组药物不良反应发生率比较,差异无统计学意义(P>0.05)。结论对重症颅脑损伤患者采用乌司他丁联合依达拉奉治疗能够明显减轻氧化应激反应,改善其神经功能及脑血流灌注。

Objective To investigate the clinical efficacy of uinastatin and edaravone on neurological function in patients with severe brain injury.Methods Ninety-eight patients with severe craniocerebral injury were randomly divided into treatment group and control group,with 49 cases in each group.Both groups received the same conventional treatment.On the basis of this,control group was given edaravone for injection 30 mL dissolved in normal saline 100 mL intravenously,twice a day.Treatment group was additionally given ulinastatin injection 4 mL dissolved in normal saline 100 mL intravenously,twice a day,and both groups were treated for 2 weeks.Oxidative stress indicators[malondialdehyde(MDA),superoxide dismutase(SOD)],neurological function indicators[neuron-specific enolase(NSE),N telencephalon sodium peptide precursor(NT-pro-BNP)],cerebral blood perfusion[cerebral blood flow(CBF),cerebral blood volume(CBV)],clinical efficacy and the incidence of adverse drug reactions in two groups were compared.Results The effective rate of treatment group was 95.92%,higher than that of control group,which was 83.67%,and there was no statistical significance between the two groups(P>0.05).After treatment,MDA in treatment group and control group were(6.01±1.58),(8.04±2.20)nmol·L^(-1);SOD were(103.02±12.54),(90.66±10.68)kU·L^(-1);NSE were(11.40±2.37),(15.85±2.78)ng·L^(-1)0;NT-Pro-BNP were(100.57±12.69)and(90.85±10.94)pg·m L-1,respectively,and the differences were statistically significant(all P<0.05).There was no significant difference in the incidence of adverse drug reactions between the two groups(P>0.05).Conclusion Ulinastatin combined with edaravone can significantly reduce oxidative stress response and improve neurological function and cerebral blood perfusion in patients with severe brain injury.