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目的 探讨促红细胞生成素(erythropoietin,EPO)对破裂动脉瘤引起的神经功能缺失的保护机制.方法 颅内动脉瘤破裂出血患者180例,随机分为对照组及治疗组,每组90例.治疗组患者从术后第1 d 开始给予EPO皮下注射,连用3 d;对照组患者应用生理盐水代替,其余治疗相同.对比两组患者在入院后当天和术后7 d、14 d、21 d、28 d、35 d的美国国立卫生研究院卒中量表(NIHSS)评分,以及术后7 d、14 d、21d、28d、35d的脑缺血体积缩小的比率.检测分析两组患者术后1d、4d、7d、10d、14d的脑脊液特异性烯醇化酶(NSE)和白介素6(IL-6)的水平.结果 治疗组术后第21 d、28 d、35 d的NIHSS评分分别为8.8 ± 1.6、8.2 ±1.5、7.2 ±1.3,对照组分别为11.4 ±2.1、10.5 ±2.0、10.3 ±2.0;两组相比差异均有统计学意义(均P<0.05).两组脑缺血体积缩小比率比较,治疗组术后第21 d、28 d、35 d的脑缺血体积缩小(20.6 ±3.7)%、(29.1 ±6.0)%和(31.7 ±5.2)%,明显高于对照组的(15.7 ±3.0)%、(19.0 ±3.4)%、(19.1 ±3.0)%,差异均有统计学意义(均P<0.05).治疗组术后第7 d、10 d、14 d的脑脊液NSE和IL-6含量明显低于对照组,差异有统计学意义(均P<0.05).结论 EPO能促进破裂动脉瘤患者的神经功能恢复,缩小脑缺血体积,降低脑脊液炎性因子水平;值得临床推广应用.“,”Objective To investigate the protective mechanism of erythropoietin(EPO)on neurological deficits caused by ruptured aneurysms.Methods A total of 180 patients with ruptured intracranial aneurysms were selected,meanwhile the control group and the treatment group were randomly divided with 90 cases in each group.The treatment group was given a hypodermic injection of EPO from the first day after the operation for three days,while the control group was replaced by normal saline,and the remaining treatment was the same.The NIHSS scores of the two groups were compared on admission,7 d,14 d,21 d,28 d and 35 d after the admission.And the changes of specific enolase(NSE)and interleukin 6(IL-6)in cerebrospinal fluid(CSF)of the two groups of patients after 1 d,4 d,7 d,10 d,and 14 d were analyzed.Results The NIHSS scores of 21 d,28 d and 35 d after operation in the treatment group were 8.8 +1.6,8.2 +1.5 and 7.2 +1.3, respectively,while the scores of control group were 11.4 +2.1,10.5 +2 and 10.3 +2 respectively.The two groups were compared(P <0.05),and the difference was statistically significant.Through the comparison of the percentage reduction of cerebral ischemia volume between the two groups,the reduction rates of 21 d,28 d and 35 d cerebral ischemia volume in the treatment group were(20.6 ±3.7)%,(29.1 ±6)%,(31.7 ±5.2)%,which were significantly higher than that in the control group(15.7 ±3)%,(19 ±3.4)%,(19.1 ±3.0)%.The difference between the two groups was statistically significant(P<0.05).The content of NSE and IL-6 in cerebrospinal fluid (CSF)in the treatment group was lower than that of the control group on 7 d,10 d and 14 d after operation,and the difference between the two groups was statistically significant(P <0.05). Conclusion EPO can promote the recovery of the progressive function of ruptured aneurysm,and it is worthy of clinical application.