环孢霉素A在改善弥漫性轴索损伤患者神经功能及氧代谢中的效果  

The effect of Cyclosporine A on improving neural function and oxygen metabolism in patients with diffuse axonal injury

作　　者：凌成明[1] 范双民[2] 

机构地区：[1]武警四川总队医院神经外科,四川乐山614000 [2]四川大学华西医院,四川成都610041

出　　处：《西部医学》2015年第6期831-833,836,共4页Medical Journal of West China

基　　金：四川省卫生厅科研课题(110610)

摘　　要：目的评价环孢霉素A在改善弥漫性轴索损伤(DAI)患者神经功能及氧代谢中的效果。方法将58例弥漫性轴索损伤患者随机分成试验组和对照组各29例。试验组采用常规疗法联合环孢霉素A(Cyclosporin A,CsA)治疗,对照组采用常规疗法联合尼莫地平治疗,分别于治疗1、3、7、14d采集患者血清及脑脊液检测糖分解烯醇酶(2-phospho-D-glycerate hydrolase,NSE)及髓鞘碱性蛋白(Myelin Basic Protein,MBP)水平,比较两组NSE及MBP水平,观察CsA对患者神经功能的作用。并于治疗前后监测两组患者脑氧代谢指标CaO2、CERO2、CjvO2及SjvO2,比较两组之间的差异,观察CsA对患者氧代谢的影响;以格拉斯哥昏迷评分(GCS)和GOS预后评分判定疗效。结果 CsA治疗组患者血清及脑脊液NSE和MBP水平均较对照组显著降低(均P<0.05),氧代谢指标较对照组也明显升高(P<0.05),且治疗后GCS和GOS评分均高于对照组,差异有统计学意义(均P<0.05),显效率也高于对照组,差异有统计学意义(P<0.05)。结论 CsA应用于DAI患者,能有效改善其神经功能及氧代谢,并可改善患者预后和康复,效果优于对照组,值得临床推广应用。Objective To evaluate the effects of cyclosporine A in improving neural function and oxygen metabo- lism in patients with diffuse axonal injury. Methods 58 patients with diffuse axonal injury were randomly divided into experimental group and control group with 29 cases in each group. The test group with conventional therapy combined with cyclosporine A （Cyclosporin, A, CsA） treatment, the control group with conventional therapy combined with nimo- dipine treatment, respectively for 1, 3, 7, serum and cerebrospinal fluid of patients with 14d collecting and detecting sug- ar decomposition enolase （2-phospho-D-glycerate hydrolase, NSE） and myelin basic protein （Myelin Basic Protein, MBP） level, NSE and MBP levels were compared between the two groups, to observe the effects of CsA on neurological function. And the monitoring of the two groups of patients with cerebral oxygen metabolism indexes of CaO2 , CERO2, CjvOz and SjvO2 before and after treatment, compared the differences between the two groups, to observe the effects of CsA on oxygen metabolism in patients with; by Glasgow Coma Scale （GCS） and the GOS score to judge the curative effect. Results Both the serum and CSF MBP and NSE level of experimental group patients were decreased significantly than the control group （P〈0.05）, oxygen metabolism index also obviously higher than the control group （P〈0.05）, and GCS and GOS scores after treatment were higher than the control group, the difference was statistically significant （P〈0.05）, the efficiency is also higher than the control group, the difference was statistically significant （P〈0.05）. Conclusion CsA can effectively improve the neurological function and oxygen metabolism in patients with DAI, it also can improve the patients＇ prognosis and rehabilitation, the effect is better than that of control group, it is worth clinical promotion.

关 键 词：弥漫性轴索损伤 环孢霉素A 神经功能 氧代谢 效果 

分 类 号：R651[医药卫生—外科学]