山莨菪碱对重型弥漫性轴索损伤患者血浆NSE、ET及CGRP含量的影响  

The effects of anisodamine on NSE,ET,and CGRP in the treatment of severe diffuse axonal injury

作　　者：赵灵[1] 林小华[2] 李永波[1] 韦玉文[1] 侯玉宇[1] 楚磊[1] 

机构地区：[1]暨南大学医学院第三附属医院外科ICU,珠海519000 [2]中山市人民医院神经外科

出　　处：《中华急诊医学杂志》2006年第3期209-212,共4页Chinese Journal of Emergency Medicine

摘　　要：目的探讨山莨菪碱对重型弥漫性轴索损伤(DAI)患者血浆神经元特异性烯醇酶(NSE)、内皮素(ET)及降钙素基因相关肽(CGRP)含量的作用及预后的影响。方法38例诊断为弥漫性轴索损伤且GCS评分为3～8分的患者被随机分成两组:治疗组(n=19)和对照组(n=19)。治疗组的患者入院后立即给予静脉持续滴注山莨菪碱0.5mg/(kg·24h),连用1周;对照组按普通常规治疗。两组患者分别于治疗前、治疗后1周采静脉血,用放射免疫法测定两组患者血浆中NSE、ET、CGRP的变化,并于伤后6个月用格拉斯哥预后评分(GOS)进行预后评定及进行统计。结果治疗组和对照组血清NSE、ET、CRPT分别为(26.70±19.73)μg/L、(36.45±8.64)ng/L、(19.93±4.32)ng/L和(49.17±23.10)ng/L、(57.31±11.14)ng/L、(23.64±6.38)ng/L,两组ET、NSE含量相比较,差异有显著性(P<0.01),治疗组生存率较对照组明显提高,差异有显著性(P<0.01)。结论使用山莨菪碱治疗弥漫性轴索损伤可降低ET和CGRP的活性,减轻脑血管痉挛所造成的脑缺血缺氧,从而提高疗效。Objective To observe the clinical effects of anisodamine on NSE, ET, and CGRP in the treatment of severe diffuse axonal injury （DAI）. Methods Thirty-eight DAI patients with Glasgow Coma Scale （GCS） 3 to 8 were divided randomly into two groups： treatment group （n = 19） and control group （n = 19）. Patients in treatment group received anisodamine 0.5 mg/ （kg·24 h） intravenously immediately after admission for 7 days. The patients in control group were dealed with common method. Serum neuron specific enolase （NSE）, endothelin （ET）, calcitonin gene-related pepfide （CGRP） were measured by radio immunoassay before and one week after treatment; and GOS was measured at 6 monthes after injury. Results The serum NSE, ET, CGRP in the treatment group were （26.70±19.73） μg/L, （36.45±8.64） ng/L, （19.93±4.32） ng/L; while in the control group were （49.17±23.10） μg/L, （57.31±11.14） ng/L, （23.64±6.38） ng/L. Between the two groups NSE, ET and survival rate were significantly different （P 〈 0.01）. Conclusion Anisodamine in the treatment of diffuse axonal injury can reduce the activation of ET and CGRP, alleviate vasospasm, and improve cerebral hypoxia and curative effect.

关 键 词：山莨菪碱 弥漫性轴索损伤 神经元特异性烯醇酶 降钙素基因相关肽 内皮素 

分 类 号：R651.15[医药卫生—外科学] R271.11[医药卫生—临床医学]