【摘要】 目的探讨神经节苷脂钠联合复方甘露醇治疗急性重症颅脑损伤的临床疗效。方法选取医院2016年6月至2017年6月收治的急性重症颅脑损伤患者93例,采用随机数字表法分为对照组(46例)和观察组(47例)。对照组患者给予复方甘露醇5 m L/kg静脉滴注,连续治疗8周。观察组患者在对照组治疗基础上加用神经节苷脂钠注射液100 mg静脉滴注,治疗2周后减量至40 mg,再继续治疗6周。结果治疗后4,8周患者星形胶质源性蛋白(S100β)、神经元特异性烯醇化酶(NSE)、胶质纤维酸性蛋白(GFAP)、泛素羧基末端水解酶L1(UCH-L1)、超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均低于治疗前(P<0.05),且观察组下降更显著(P<0.05);两组患者神经生长因子(NGF)、脑源性神经营养因子(BDNF)水平均显著高于治疗前(P<0.05),且观察组上升更显著(P<0.05)。随访半年,观察组患者临床治愈率为57.45%,高于对照组的36.96%(P<0.05);两组患者不良反应比较无明显差异(P>0.05)。结论神经节苷脂钠联合复方甘露醇治疗急性重症颅脑损伤,可有效减少患者神经损伤因子的表达,促进神经营养因子的合成活化,减少炎性介质释放,预后较好,值得临床推广。更多还原

【Abstract】 Objective To investigate the clinical effect of ganglioside sodium combined with compound mannitol in the treatment of acute severe craniocerebral injury. Methods Totally 93 patients with acute severe craniocerebral injury admitted to our hospital from June2016 to June 2017 were selected and divided into the control group( n = 46) and the observation group( n = 47) according to random number table method. The control group was given intravenous drip of mannitol 5mL/kg for 8 weeks, on this basis, the observation group was given intravenous drip of ganglioside sodium 100 mg for 2 weeks and then reduced to 40 mg for another 6 weeks. Results4, 8 weeks after treatment, the levels of S100β, NSE, GFAP, UCH-L1, hs-CRP, IL-6, TNF-α in the two groups were significantly lower than those before treatment( P < 0. 05), and those in the observation group were significantly lower than those in the control group( P < 0. 05). The levels of NGF and BDNF in the two groups were significantly higher than those before treatment( P < 0. 05),and those in the observation group were significantly higher than those in the control group( P < 0. 05). After 6 months of follow-up,the clinical cure rate in the observation group was 57. 45%,which was significantly higher than 36. 96% in the control group( P < 0. 05).There was no significant difference in the incidence rate of adverse reactions between the two groups( P > 0. 05). Conclusion Ganglioside combined with compound mannitol in the treatment of acute severe craniocerebral injury can effectively reduce the expression of nerve injury factor, promote the synthesis and activation of neurotrophic factor, reduce the inflammatory mediators and has better prognosis,which is worthy of clinical promotion.更多还原