地塞米松对重型颅脑损伤患者C反应蛋白和血浆内皮素-1的影响及临床意义  

Effect of dexamethasone on C-reactive protein and endothelin-1 in patients with severe traumatic brain injury and clinical significance of the changes

作　　者：刘国胜 栾晓祖 朱铭 彭赛亮[2] 赵志勇[3] 

机构地区：[1]厦门市海沧医院神经外科,福建361026 [2]厦门市第二医院检验科,福建361026 [3]兰州大学第二医院神经外科,甘肃730030

出　　处：《创伤外科杂志》2015年第5期403-406,共4页Journal of Traumatic Surgery

摘　　要：目的研究地塞米松对重型颅脑损伤患者C反应蛋白（CRP）和血浆内皮素-1（ET-1）的影响并探讨其临床意义。方法 78例重型颅脑损伤患者随机分为地塞米松治疗组（39例）和对照组（39例）,男性40例,女性38例;年龄11--76岁,平均42.5岁。致伤原因：道路交通伤38例,高处坠落伤25例,殴打伤12例,其他伤3例。所有患者均给予常规治疗,治疗组患者在此基础上加用地塞米松注射液20mg加0.9%氯化钠注射液静滴治疗,每天一次,连用7d。测定两组患者第1、3、5、7、14天CRP和ET-1的变化。观察两组患者相应时间点格拉斯哥昏迷评分（GCS）。结果治疗第1天两组患者ET-1水平无明显变化（P〉0.05）,CRP水平低于对照组（P〈0.01）。治疗组患者第3、5、7、14天ET-1和CRP水平均低于对照组。两组患者治疗第1天GCS评分差异无统计学意义（P〉0.05）,治疗组患者第3、5、7天GCS评分值均显著高于对照组（P〈0.05）。结论地塞米松可使重型颅脑损伤患者CRP和ET-1水平显著下降,改善重型颅脑损伤患者GCS评分。Objective To explore the effects of dexamethasone injection on C-reactive protein and endothe-lin-1 in patients with severe traumatic brain injury and clinical significance of the changes. Methods Seventy-eight patients with severe traumatic brain injury were randomly divided into dexamethasone treatment group and con-trol group with 39 patients in each group.All patients received conventional therapy and patients in dexamethasone treatment group were given an additional treatment with dexamethasone injection.Levels of C-reactive protein and endothelin-1 were monitored in all patients on day 1,3,5,7,and 14 after therapy.And Glasgow coma scale （GCS） were observed in all patients at the same time point.Results There was no obvious change in endothelin-1 on day 1 after therapy in either group （P〉0.05）.But obvious changes were found in C-reactive protein on day 1 after therapy in both groups（P〈0.01）.Compared with the control group,C-reactive protein and endothelin-1 in the dexamethasone treatment group decreased significantly on day 3,5,7 and 14 after therapy.There was no obvious change on GCS on day 1 after therapy in either group（P〉0.05）.Compared with the control group,GCS increased on day 3,5 and 7 after therapy（P〈0.05）.Conclusion Dexamethasone can significantly reduce the levels of C-reactive protein and endothelin-1 and improve GCS in patients with severe traumatic brain injury.

关 键 词：颅脑损伤 地塞米松 C反应蛋白 内皮素-1 

分 类 号：R651.15[医药卫生—外科学]