【摘要】 目的探讨8-表氧前列腺素F2α(8-iso-PGF2α)在重型颅脑损伤患者血浆中的水平和在抗氧化剂疗效评估中的价值。方法对自2003年1月至2004年12月收住的98例重型颅脑损伤患者以2004年4月为界分为前期68例,后期30例。前期病例根据随机原则分成:常规治疗组和加用抗氧化剂VitC+VitE治疗组,各34例;后期病例给予新型抗氧化剂依达拉奉治疗。同时设健康体检者对照组40例。在受伤第1、2、3、7、14、30天,分别对存活患者清晨空腹采取肘静脉血3mL,对照组亦同。采用ELISA法测定血浆8-iso-PGF2α含量。以三个月为限,根据GOS标准分成死亡、恢复不良(包括植物生存、重残与中残)和恢复良好。结果用抗氧化剂治疗组受伤第7天、第14天血浆8-iso-PGF2α检测值比常规治疗组明显下降(P<0.05)。而常规治疗组两周内5次血浆8-iso-PGF2α的检测值均高于对照组(P<0.01)。伤后3月时,VitC+VitE治疗组死亡率41.18%,常规治疗组死亡率64.71%,依达拉奉治疗组死亡率33.33%。结论抗氧化剂能够明显降低重型颅脑损伤患者血浆8-iso-PGF2α的水平,依达拉奉能显著降低重度颅脑损伤患者死亡率。血浆8-iso-PGF2α的动态变化能够作为重型颅脑损伤患者抗氧化剂疗效评估的一项有效的生化指标。更多还原

【Abstract】 Objective To study the value of plasma 8-iso-prostaglandin F2α(8-iso-PGF2α) in evaluating the curative effect of antioxidants in the patients with severe brain injury. Methods In this study, the plasma levels of 8-iso-PGF2α were measured by ELISA method in 98 patients with severe brain injury at 1st, 2nd, 3rd, 7th, 14th and 30th day after injury. The plasma levels of 8-iso-PGF2α in 40 healthy volunteers were measured as controls. Of the 98 patients with severe brain injury, 68 were divided randomly into conventional treatment group (n=34), VitC+VitE treatment group (n=34); 30 patients were treated with edaravon. According to GOS within 3 months after treatment, the dignosis included 3 grades: death, poor outcome and good outcome. Results The plasma levels of 8-iso-PGF2α in patients with severe brain injury were significantly higher than those of the controls (P<0.01). After the treatment of antioxidants (VitC+VitE) and free radical scavengers (edaravon) for 7 d and 14 d, the plasma 8-iso-PGF2α levels were significantly lower than conventional treatment group (P<0.05). The mortality rate of conventional treatment group (64.71%) was higher than that of VitC+VitE treatment group (41.18%) and edaravon treatment group (33.33%). Conclusion It can be inhibited by antioxidants. So it could be a specific index of lipid peroxidation in vivo and curative effect of antioxidants.更多还原