摘要
目的:探讨神经节苷脂联合脑苷肌肽治疗创伤性颅脑损伤(TBI)的临床价值。方法:选取TBI患者102例,根据随机数字表法将患者分为脑苷肌肽组(51例)和联合组(51例)。在常规治疗基础上,脑苷肌肽组给予脑苷肌肽治疗,联合组联合应用脑苷肌肽和神经节苷脂治疗。比较两组患者治疗前后神经功能评估指标、神经损伤及营养指标、脑血流动力学指标以及预后指标。结果:治疗后两组患者格拉斯哥昏迷评分(GCS)、简易精神状态检查量表(MMSE)评分高于治疗前,美国国立卫生研究院卒中量表(NIHSS)评分低于治疗前(均P<0.05)。联合组治疗后GCS评分、MMSE评分高于脑苷肌肽组,NIHSS评分低于脑苷肌肽组(均P<0.05)。治疗后,两组患者神经特异性烯醇化酶(NSE)、胶质纤维酸性蛋白(GFAP)和泛素羧基末端水解酶L1(UCH-L1)水平低于治疗前,且联合组低于脑苷肌肽组(均P<0.05)。治疗后,两组患者脑源性神经营养因子(BDNF)、神经生长因子(NGF)和超氧化物歧化酶(SOD)水平高于治疗前,且联合组高于脑苷肌肽组(均P<0.05)。治疗后,两组患者脑血流量(CBF)高于治疗前,阻力指数(RI)、平均血流速度(Vm)低于治疗前,且联合组患者CBF高于脑苷肌肽组,RI、Vm低于脑苷肌肽组(均P<0.05)。治疗后3个月,联合组预后良好占比高于脑苷肌肽组(P<0.05)。结论:神经节苷脂联合脑苷肌肽治疗TBI能够改善神经功能和脑血流动力学,降低神经损伤和应激水平,提高神经营养状态,改善预后。
Objective:To investigate the clinical value of ganglioside combined with cattle encephalon glycoside ignotin in the treatment of traumatic brain injury(TBI).Methods:A total of 102 TBI patients were selected and divided into cattle encephalon glycoside ignotin group(51 cases)and combined group(51 cases)according to random number table method.On the basis of conventional treatment,the cattle encephalon glycoside ignotin group was treated with cattle encephalon glycoside ignotin,and the combined group was treated with cattle encephalon glycoside ignotin and ganglioside.Neurological function evaluation indexes,neurological injury and nutritional indexes,cerebral hemodynamic parameters before and after treatment and prognostic indexes were compared between the two groups.Results:After treatment,Glasgow Coma Score(GCS)and Mini-Mental State Examination(MMSE)scores in the two groups were higher than those before treatment,and National Institutes of Health Stroke Scale(NIHSS)scores were lower than those before treatment(all P<0.05).After treatment,the GCS score and MMSE score of the combined group were higher than those of cattle encephalon glycoside ignotin group,and the NIHSS score was lower than that of cattle encephalon glycoside ignotin group(all P<0.05).After treatment,the levels of neuron-specific enolase(NSE),glial fibrillary acidic protein(GFAP)and ubiquitin carboxy-terminal hydrolase L1(UCH-L1)in two groups were lower than those before treatment,and those in the combined group were lower than those in the cattle encephalon glycoside ignotin group(all P<0.05).After treatment,the levels of brain-derived neurotrophic factor(BDNF),nerve growth factor(NGF)and superoxide dismutase(SOD)in two groups were higher than those before treatment,and those in combined group were higher than those in the cattle encephalon glycoside ignotin group(all P<0.05).After treatment,cerebral blood flow(CBF)in two groups was higher than that before treatment,Resistance Index(RI)and mean flow velocity(Vm)were lower than those before treatment,and CBF in the combined group was higher than that in cattle encephalon glycoside ignotin group,RI and Vm were lower than those in cattle encephalon glycoside ignotin group(all P<0.05).At three months after treatment,the proportion of good prognosis in the combined group was higher than that in cattle encephalon glycoside ignotin group(P<0.05).Conclusion:The gangliosides combined with cattle encephalon glycoside ignotin in the treatment of TBI can improve neurological function and cerebral hemodynamics,reduce neurological injury and stress level,enhance neurotrophic status,and improve prognosis.
作者
李俊梅
米丹丽
李建英
刘燕
LI Junmei;MI Danli;LI Jianying;LIU Yan(Department of Critical Care Medicine,Zhangjiakou First Hospital,Zhangjiakou 075000,China)
出处
《陕西医学杂志》
CAS
2024年第8期1092-1096,共5页
Shaanxi Medical Journal
基金
河北省自然科学基金青年基金资助项目(H2020206278)。
关键词
创伤性颅脑损伤
神经节苷脂
脑苷肌肽
神经功能
脑血流动力学
预后
Traumatic brain injury
Ganglioside
Cattle encephalon glycoside ignotin
Neurological function
Cerebral hemodynamics
Prognosis
