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目的观察急性脑出血患者应用依达拉奉治疗对血清IL-6、TNF-α水平的影响以及神经功能缺损评分的变化,以探讨依达拉奉参与脑出血患者神经功能保护的机制。方法选择2013年6月—2014年8月收治的脑出血患者86例作为研究对象,随机分成对照组42例和治疗组44例。对照组给予常规治疗,治疗组在对照组的基础上加用依达拉奉30 mg/次,2次/d,两组均治疗14 d。分别于治疗的第1、7、14天应用ELISA法检测两组患者血清中TNF-α和IL-6水平,同时对患者进行神经功能缺损评分。计量资料组间比较采用t检验,组内比较采用配对t检验,P<0.05为差异有统计学意义。结果治疗第1、7、14天对照组IL-6水平分别为(63.8±11.2)、(49.7±8.2)、(40.5±7.4)ng/L,治疗组分别为(62.3±10.1)、(43.9±6.7)、(28.6±5.3)ng/L,对照组TNF-α水平分别为(41.8±5.9)、(34.2±4.9)、(26.7±4.2)ng/L,治疗组分别为(42.5±6.1)、(28.9±4.3)、(17.5±3.8)ng/L,对照组美国国立卫生研究院脑卒中量表(national institute of health stroke scale,NIHSS)评分分别为(20.5±4.4)、(18.2±3.7)、(16.3±3.4)分,治疗组分别为(20.3±4.5)、(16.5±3.2)、(12.7±2.8)分,两组治疗第7、14天血清IL-6和TNF-α水平及NIHSS评分均明显低于治疗第1天,差异均有统计学意义(均P<0.05)。治疗后各观察指标两组间差异均有统计学意义(均P<0.05)。结论依达拉奉能改善脑出血患者神经功能缺损,降低血清中TNF-α和IL-6的产生,减轻脑出血患者脑组织的炎性反应,起到脑保护作用。
Objective To observe the effect of edaravone on the level of serum IL-6 and TNF-α in patients with acute cerebral hemorrhage and the changes of neurological deficit score to explore the mechanism of edaravone’s neuroprotection in patients with intracerebral hemorrhage. Methods 86 patients with cerebral hemorrhage admitted from June 2013 to August 2014 were randomly divided into control group (n = 42) and treatment group (n = 44). The control group was given routine treatment. The treatment group was treated with edaravone 30 mg twice daily for 14 days on the basis of the control group. Serum levels of TNF-α and IL-6 were measured by ELISA on the 1st, 7th and 14th day of treatment, respectively. Neurological deficits were also evaluated. Measurement data were compared between groups using t test, the group was compared using paired t test, P <0.05 for the difference was statistically significant. Results The levels of IL-6 in the control group were (63.8 ± 11.2) and (49.7 ± 8.2) and (40.5 ± 7.4) ng / L on the 1st, 7th and 14th day after treatment, respectively, and were 62.3 ± 10.1 and 43.9 ± 6.7 and 28.6 ± 5.3 ng / L, respectively. The levels of TNF-α in the control group were (41.8 ± 5.9) and (34.2 ± 4.9) and (26.7 ± 4.2) ng / L, ), (28.9 ± 4.3) and (17.5 ± 3.8) ng / L, respectively. The NIH scores of the NIH SLE were (20.5 ± 4.4) and (18.2 ± (16.3 ± 3.4), (16.5 ± 3.2) and (12.7 ± 2.8) points in the treatment group respectively. Serum levels of IL-6 and TNF-α And NIHSS scores were significantly lower than the first day of treatment, the differences were statistically significant (P <0.05). After treatment, the differences between the two groups were statistically significant (P <0.05). Conclusion Edaravone can improve neurological deficits, reduce the production of TNF-α and IL-6 in serum, alleviate the inflammatory reaction in brain tissue of patients with cerebral hemorrhage, and play a neuroprotective role.