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目的探讨重组人促红细胞生成素(r Hu-EPO)对重型颅脑损伤患者的神经保护作用及对血清神经元特异性烯醇化酶(NSE)和白细胞介素-6(IL-6)水平的影响。方法选择重型颅脑损伤患者110例,随机分为EPO治疗组(58例)和对照组(52例)。EPO治疗组于入院治疗当天,第3、6、9、12天给予r Hu-EPO 6 000 IU皮下注射。对照组同时给予安慰剂处理,其他治疗相同。采用格拉斯哥昏迷评分(GCS)和格拉斯哥预后评分(GOS)评价神经功能损伤恢复程度和患者预后情况。采用ELISA法检测两组血清神经元特异性烯醇化酶(NSE)、IL-6水平,采用氰化高铁血红蛋白法检测血红蛋白,汞柱血压计测血压,并进行比较。结果治疗后7、10、14 d,EPO治疗组血清中NSE、IL-6水平低于对照组(P均<0.05);治疗后14 d,EPO治疗组GCS明显高于对照组(12.13±3.42 vs 9.39±3.24)(P<0.05);治疗后6个月,EPO治疗组GOS明显高于对照组(4.81±0.56 vs 3.26±0.39)(P<0.05);EPO治疗组未出现由EPO导致的发热、皮疹、瘙痒等不良作用。结论 r Hu-EPO可能通过降低重型颅脑损伤患者血清NSE及IL-6水平减轻其神经损伤。
Objective To investigate the neuroprotective effect of recombinant human erythropoietin (r Hu-EPO) on patients with severe craniocerebral injury and its effect on serum levels of neuron specific enolase (NSE) and interleukin-6 (IL-6) influences. Methods One hundred and ten patients with severe craniocerebral injury were randomly divided into EPO treatment group (58 cases) and control group (52 cases). EPO treatment group on the day of admission treatment, on the 3rd, 6th, 9th and 12th days, r Hu-EPO 6 000 IU subcutaneous injection. The control group was given placebo at the same time, other treatments were the same. Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS) were used to assess the extent of recovery of neurologic impairment and the prognosis of patients. Serum levels of neuron specific enolase (NSE) and IL-6 were detected by ELISA. Blood pressure was measured by cyanmethemoglobin and blood pressure were measured by mercury barometer. Results Serum levels of NSE and IL-6 in EPO group were significantly lower than those in control group at 7, 10 and 14 days (P <0.05). At 14 days after treatment, GCS in EPO group was significantly higher than that in control group (12.13 ± 3.42 vs 9.39 ± 3.24) (P <0.05). At 6 months after treatment, the GOS of EPO group was significantly higher than that of control group (4.81 ± 0.56 vs 3.26 ± 0.39) (P <0.05) Fever, rash, itching and other adverse effects. Conclusions r Hu-EPO may reduce the neurological damage by decreasing the levels of serum NSE and IL-6 in patients with severe craniocerebral injury.