黄体酮对重度颅脑损伤患者血清TNF-α、IL-1β和预后的影响  

Effect of progesterone on serum TNF-α,IL-1β and prognosis in patients with severe traumatic brain injury

作　　者：陆林其[1] 盛罗平[1] 李季林[1] 陈仁辉[1] 朱卫[2] 

机构地区：[1]复旦大学附属中山医院青浦分院神经外科,上海201700 [2]复旦大学附属中山医院神经外科

出　　处：《创伤外科杂志》2012年第2期157-160,共4页Journal of Traumatic Surgery

基　　金：上海市青浦区卫生局资助(qw2009-2)

摘　　要：目的探索黄体酮对重度颅脑损伤(TBI)患者血清中炎症因子肿瘤坏死因子α(TNF-α)、白细胞介素-1β(IL-1β)的影响及临床意义。方法将65例重度颅脑损伤(TBI)患者按完全随机分组方法分为对照组和黄体酮组。对照组行必要的神经外科处理及常规药物治疗;黄体酮组在上述治疗的基础上,加用黄体酮治疗1.0mg/(kg.d),连用3d。采用酶联免疫吸附测定法(ELISA)检测两组患者伤后第1、3、5天血清中TNF-α、IL-1β的含量。伤后3个月采用格拉斯哥预后评分(GOS)对患者预后进行评估。结果伤后第1天TNF-α、IL-1β的含量黄体酮组和对照组无明显差异(P>0.05),均和正常对照组有差异(P<0.05)。伤后第3、5天,TNF-α、IL-1β的含量黄体酮组下降较对照组明显(P<0.05)。伤后3个月GOS评估结果显示,黄体酮组预后良好患者明显多于对照组(P<0.05)。结论黄体酮治疗颅脑损伤患者可以降低血清TNF-α、IL-1β含量,促进神经功能的恢复,提高临床疗效。Objective To explore the effect of progesterone on tumor necrosis factor alpha（TNF-α）,interleukin-1β（IL-1β）in serum of patients with severe traumatic brain injury and its clinical significance.Methods Sixty-five patients with severe traumatic brain injury were randomly divided into the progesterone group and control group.The control group was performed neurosurgical treatment and necessary conventional medical treatment;the progesterone group was treated on the basis of the above,plus progesterone treatment,1.5mg/kg,were given every day for 3 days.ELSIA assay was used for two groups of patients at postinjury 1,3,5 days for detecting serum TNF-α,IL-1β levels.After injury for 3 months,GOS score was used to assess patients＇ prognosis.Results At post injury 1 day,there was no significant difference in the levels of TNF-α,IL-1β between the progesterone and control groups（P0.05）,but significant difference with the control group（P0.05）.At post injury 3 and 5 days,TNF-αand IL-1β levels of progesterone group was more remarkably decreased than those in the control group（P0.05）.At 3 months post injury,GOS score showed that there were more patients with good prognosis in progesterone group than the control group（P0.05）.Conclusion Progesterone treatment for traumatic brain injury patients can reduce serum TNF-α,IL-1β levels,and promote recovery of neurological function and improve clinical efficacy.

关 键 词：颅脑损伤 黄体酮 肿瘤坏死因子-Α 白细胞介素-1Β 

分 类 号：R651.15[医药卫生—外科学]