依达拉奉联合亚低温治疗重型颅脑创伤的疗效及对血清TNF-α、IL-6及神经功能的影响

Effects of Edaravone Combined with Mild Hypothermia In the Treatment of Severe Craniocerebral Trauma and Influence on Serum TNF-α, IL-6 and Neurological Function

目的:探讨依达拉奉联合亚低温治疗重型颅脑创伤患者临床效果及对血清TNF-α、IL-6及神经功能的影响。方法:选择我院2014年7月-2016年10月收治且经患者或家属签字同意参与研究的76例重型颅脑患者作为研究对象,按照随机数字表法分为两组,各38例。其中对照组采用常规手术及药物治疗,治疗组在对照组治疗基础上辅以亚低温、依达拉奉(30 mg+0.9%氯化钠注射液100 m L,静脉滴注,30 min内滴注完,bid,共14 d)。分别于治疗前后抽取全血分离后检测其血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6水平,采用神经功能缺损量表(NIHSS)评价两组患者治疗前后神经功能变化,采用格拉斯哥昏迷量表(GCS)评价两组患者预后,并利用经颅多普勒超声检测患者大脑中动脉平均血流速度(Vm)。结果:两组患者治疗后IL-6、TNF-α水平显著低于治疗前(P<0.05),治疗组治疗后IL-6、TNF-α水平分别为(9.11±1.96)ng/L,(39.76±4.68)ng/L,显著低于对照组(11.69±2.38)ng/L,(46.85±5.22)ng/L,两组比较均有统计学差异(P<0.05);两组患者治疗后NIHSS评分显著低于治疗前,Vm水平、GCS评分显著高于治疗前(P<0.05)。治疗组治疗后NIHSS评分显著低于对照组,Vm水平、GCS评分显著高于对照组(P<0.05),结论:临床采用依达拉奉联合亚低温辅助治疗重型颅脑创伤患者疗效显著,有助于改善患者预后。

objective:To investigate the clinical effect of edaravone combined with mild hypothermia in the treatment of severe craniocerebral trauma and influence on serum TNF-α, IL-6 and neurological function. Methods:76 patients with severe craniocerebral trauma were enrolled in this study from July 2014 to October 2016 and signed by patients themselves or their families. According to the random number table, they were divided into control group and treatment group, 38 for each. The control group was treated with routine operation and drug treatment. The treatment group was supplemented with mild hypothermia and edaravone(30 mg+0.9% saline 100 m L, intravenous infusion, 30 min infusion finished, 2 times/d, a total of 14 days) based on the same treatment as that for control group. The levels of serum tumor necrosis factor(TNF)-α and interleukin(IL)-6 were measured before and after treatment through whole blood collected and separated. The Nerve function defect scale(NIHSS) was used to evaluate the neurological deficits. The mean blood flow velocity(Vm) of the middle cerebral artery was measured by transcranial Doppler ultrasonography and the Glasgow coma scale(GCS) was used to evaluate prognosis. Results:The levels of IL-6 and TNF-α in treatment group were(9.11±1.96) ng/L and(39.76±4.68) ng/L, respectively, which were significantly lower than those in the control group [(11.69±2.38) ng/L,(46.85±5.22) ng/L]. The levels of IL-6 and TNF-α in the two groups were significantly lower than those before treatment(P<0.05). After treatment, NIHSS score was significantly lower than that in the control group, Vm level and GCS score were significantly higher than those in the control group, NIHSS score of two groups was significantly lower than before treatment, Vm level, GCS score was significantly higher than that before treatment(P<0.05). Conclusion:Edaravone with mild hypothermia showed remarkable clinical effect in the treatment of patient with severe craniocerebral, and which improve the prognosis of patients.