硫酸镁对重型颅脑损伤的治疗作用研究  

A study of the curative effect of magnesium sulfate in severe traumatic brain injury

作　　者：何百祥[1] 张瑞娟[2] 李奇[1] 汪鑫[1] 张志峰[2] 魏志超[3] 杜昌旺[1] 

机构地区：[1]西安交通大学医学院第一附属医院神经外科,710061 [2]西安交通大学医学院公共卫生系营养与食品卫生学教研室 [3]西安交通大学医学院医学检测中心

出　　处：《中国急救医学》2010年第5期406-409,共4页Chinese Journal of Critical Care Medicine

基　　金：基金项目：陕西省卫生厅科研基金项目（No.08H30）

摘　　要：目的探讨硫酸镁治疗重型颅脑损伤（sTBl）的临床效果及作用机制，方法将人选病例随机分为治疗组和对照组，每组30例。对照组按常规治疗，治疗组加用硫酸镁。分别采用原子分光光度法和放射免疫法测定治疗前后血清Mg2和白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TM-α）浓度；入院时、入院2周分别记录格拉斯哥昏迷评分（GCS）；sTBI后3个月随访记录格拉斯哥预后评分（GOS）。结果治疗组血清IL-1β浓度于治疗后2、3、7d明显低于对照组（P均〈0．01），血清TNF-α浓度于治疗后2、3d明显低于对照组（P均〈0．05）。治疗组人院2周GCS评分明显高于对照组（P〈0．05）。治疗组sTBI后3个月GOS评分高于对照组，但差异无统计学意义（P〉0．05）。结论硫酸镁治疗sTBI近期疗效良好。Mg2可通过抑制sTBI患者急性期炎症反应而起到脑保护作用。Objective To investigate the clinical curative effect and the mechanism of magnesium sulfate in severe traumatic brain injury. （sTBI）. Methods The enrolled patients were assigned to experimental group and control group at random,30 cases in each group. Patients in control group received conventional therapy. Besides conventional treatment, the patients in experimental group were treated with magnesium sulfate additionally. The levels of Mg2 ＋ and IL -1β, TNF -α in serum were measured by atomic spectrometry and radioimmunoassay respectively. Patient＇s GCS was recorded at admission and 2 weeks later. Patient＇s GOS was recorded at 3 months later. Results Serum IL -1β levels in experimental group on 2, 3, 7 flay ＂after sTBI were significantly lower compared with those in control group（ P 〈0. 01 ） ,and serum levels of TNF -α in experimental group on 2, 3 day after sTBI were lower significantly than those in control group （ P 〈 0. 05 ）. The GCS of patients at 2 weeks in experimental group was significantly higher than that in control group（ P 〈 0. 05）. The GOS of patients at 3 months in experimental group was higher than that in control group, but there was no significant difference. Conclusion A better short - term effect appears when sTBI is treated by magnesium sulfate ; Mg2 may have brain protection effeel by inhibiting the inflammatory response in the acute phase of sTBI.

关 键 词：重型颅脑损伤 硫酸镁 白细胞介素-1Β 肿瘤坏死因子-Α 临床效果 

分 类 号：R651.15[医药卫生—外科学]