血必净对颅脑损伤后大鼠和人炎症反应与免疫功能的影响  

Effects of Xuebijing on the inflammatory reaction and immune function after traumatic brain injury

作　　者：卞晓星[1] 袁雪松[1] 朱国 戚传平[1] 

机构地区：[1]江苏大学附属武进医院神经外科,常州213002

出　　处：《中华卫生应急电子杂志》2015年第1期18-22,共5页Chinese Journal of Hygiene Rescue(Electronic Edition)

基　　金：江苏大学医学临床科技发展基金(JLY20100032)

摘　　要：目的探索中成药血必净注射液对颅脑损伤后大鼠和人的炎症反应与免疫功能的影响。方法动物实验:选择28只SD大鼠,并分成3组,1组正常对照组,另两组用改进Feeney氏法制作脑挫伤模型,然后分别分为血必净注射液A组与腹腔注射等渗盐水B组12 h/次共10次,6 h、24 h、3 d、5 d、7 d断尾取血,测S100B蛋白与IL-6含量;临床试验:GCS≤8分的重型颅脑外伤患者60例,分两组,对照组常规治疗,治疗组在常规治疗基础上早期应用血必净注射液50 ml 3次/d,连续7 d,在1 d、4 d、8 d采血,检测细胞免疫与体液免疫功能。数据采用SPSS 10.0统计分析软件,运用方差分析进行组间比较,以P<0.05为有统计学意义。结果动物实验:脑外伤后血清S100B含量在各时间点达到(26.25±16.35)pg/ml、(38.31±8.89)pg/ml、(35.61±18.40)pg/ml、(28.91±13.65)pg/ml、(26.82±10.58)pg/ml,IL-6含量在各时间点达到(46.77±14.30)pg/ml、(55.96±37.81)pg/ml、(59.14±36.60)pg/ml、(55.22±22.22)pg/ml、(46.73±13.52)pg/ml,与正常对照组相比明显升高,差异具有统计学意义(t=8.792,P<0.001);应用血必净能抑制其升高,与等渗盐水组比较差异具有统计学意义(t=12.336,P<0.001);临床试验:治疗组HLA-DR、CD3~^+、CD4~^+在第8天分别达到(57.10±7.09)%、(55.09±3.15)%、(29.68.±3.16)%高于对照组,差异具有统计学意义(t=2.674,P<0.05)。CD8~^+在第4天、8天分别为(21.33±2.42)%、(23.30±3.35)%,低于对照组,差异具有统计学意义(t=3.135,P<0.05)。结论血必净注射液应用于颅脑外伤早期,有一定的神经保护作用与提高免疫功能的作用,有望改善重型颅脑外伤的预后。Objective To explore the effects of the traditional Chinese medicine,parenteral solution of Xuebijing,on the inflammatory reaction and immune function after traumatic brain injury.Methods In the animal experimental study,30 healthy adult male Sprague-Dawley rats were randomly devided into 3 groups：one normal control group and two Xuebijing intervention groups. Physiological saline and Xuebijing were injected separately every 12 hours until 7 d after trauma.Serum samples were collected at 6 h,24 h,3 d,5 d,7 d after trauma,and the S100B protein and IL-6 content was detected with ELISA.In clinical trials,sixty patients （GCS≤8 points）were randomly devided into two groups of A （treated with conventional therapy and Xuebijing）and B （treated with conventional therapy alone）.Patients of group A were injected with Xuebijing every 8 hours until 7 d after trauma.Serum samples were collected at 1 d,4 d, and 8 d after trauma,and then cellular immunity and humoral immune function were detected.Results In the animal experiments,the serum S100B protein（26.25 ±16.35）pg/ml、（38.31 ±8.89）pg/ml、（35.61 ± 18.40）pg/ml、（28.91 ±13.65）pg/ml、（26.82 ±10.58）pg/ml and IL-6 content（46.77 ±14.30）pg/ml、（55.96 ±37.81 ）pg/ml、（59.14 ±36.60）pg/ml、（55.22 ±22.22）pg/ml、（46.73 ±13.52）pg/ml significantly increased after traumatic brain injury（t =8.792,P 〈0.001）.And compared with the control group,it was obviously inhibition in treatment group with using Xuebijing early after traumatic brain injury （t =12.336,P 〈0.001）.In the clinical trials,the HLA-DR and CD3 ＋of CD4 ＋were 8d respectively （57.10 ±7.09）%、（55.09 ±3.15）%、（29.68.±3.16）% significantly higher and the CD8 ＋ 4 d,8 d, respectively （21.33 ±2.42）%、（23.30 ±3.35）%significantly lowerthan the control group（t =3.135,P 〈0.05 ）. Conclusions Xuebijing used in the early stage of traumatic brain injury might have a neuroprotective effect and improve immune function.Accordin

关 键 词：颅脑损伤 炎症 免疫 

分 类 号：R651.15[医药卫生—外科学]