硫辛酸对急性硬脑膜下血肿患者水通道蛋白4和疗效的影响  

Effects of lipoic acid on aquaporin- 4 and efficacy in patients with acute subdural hematoma

作　　者：刘宇梁[1] 伏光辉[1] 王建伟[1] 

机构地区：[1]连云港市东方医院神经外科,江苏连云港222042

出　　处：《中国新药与临床杂志》2015年第11期857-860,共4页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的观察应用硫辛酸前后急性硬膜下血肿患者水通道蛋白4(AQP-4)血清浓度和疗效的变化,探讨硫辛酸治疗急性硬膜下血肿的可能作用机制。方法 84例急性硬膜下血肿手术患者随机分为对照组(41例)和治疗组(43例),围术期均予脱水、降颅压、营养神经、对症及支持治疗,治疗组在此基础上加用硫辛酸注射液400 mg静脉滴注,每日1次,疗程3周。另取健康体检者30例作为正常对照组。评估治疗前后对照组和治疗组患者神经功能缺损程度评分(NDS)、简式Fugl-Meyer运动功能评分(FMA)和改良Barthel指数(MBI),并检测患者血清AQP-4浓度变化。结果治疗前对照组和治疗组患者NDS评分、FMA评分和MBI无显著差异(P>0.05),治疗后两组NDS评分均下降(P<0.05),FMA评分和MBI升高(P<0.05),治疗组改善幅度大于对照组(P<0.05)。治疗期间无明显不良反应发生。治疗前对照组和治疗组患者血清AQP-4浓度无显著差异(P>0.05),且均高于正常对照组(P<0.05);治疗后两组患者的血清AQP-4浓度均降低(P<0.05),治疗组下降幅度大于对照组(P<0.05)。结论硫辛酸对急性脑膜下血肿患者的脑损伤具有一定的保护作用,减少患者伤后AQP-4的表达可能为其作用机制之一。AIM To study the effects of lipoic acid on concentration of serum aquaporin-4 （AQP-4） and efficacy in patients with acute subdural hematoma, and to explore its mechanism. METHODS Eighty-four patients undergoing operation with acute subdural hematoma were randomly divided into control group （n = 41 ） and therapy group （n = 41）. All patients were given routine therapy during perioperative period, while the patients in the therapy group were treated with lipoic acid injection 400 mg by intravenous before anesthesia induction and once daily for 3 weeks after operation besides routine therapy. Another 30 healthy subjects were selected as normal control group. The neurologic function deficits score （NDS）, the simple type of Fugl-Meyer motor function assessment （FMA） method, and modified Barthel index （MBI） were used to assess the neurologic function, extremity movement function and activities of daily living before and after the treatment. The levels of concentration of serum AQP-4 were assayed. RESULTS There were no significant difference in NDS scores, FMA scores and MBI between two groups before the treatment （P 〉 0.05）. Compared with those before the treatment, the NDS scores increased significantly after the treatment in both groups （P 〈 0.05）, whereas the FMA scores and MBI decreased significantly （P 〈 0.05）, and these changes were more significant in the therapy group （P 〈 0.05）. No obvious adverse reaction occurred in both groups during the therapy. There was no significant difference in concentration of serum AQP-4 between the two groups before the treatment （P 〉 0.05）, but they were higher than that in the normal control group （P 〈 0.05）. Compared with those before the treatment, the concentration of serum AQP-4 decreased significantly after the treatment （P 〈 0.05）, and the changes were more significant in the therapy group （P 〈 0.05） . CONCLUSION Lipoic acid may protect cerebral neurologic function from injury in patients with acute sub

关 键 词：血肿 硬膜下 急性 硫辛酸 水通道蛋白质4 药物疗法 

分 类 号：R982[医药卫生—药品]