纳美芬联合单唾液酸四己糖神经节苷脂钠用于脑肿瘤手术患者的临床观察  

Clinical Observation of Nalmefene Combined with Monosialotetrahexosylganglioside Sodium in the Treatment of Patients in Brain Tumor Operation

作　　者：王善军[1] 刘小刚[1] 张伟[1] 周帅[2] 

机构地区：[1]潍坊市益都中心医院神经外科,山东潍坊262500 [2]滨州医学院人体解剖与组织胚胎学研究所,山东滨州256603

出　　处：《中国药房》2016年第23期3221-3223,共3页China Pharmacy

基　　金：山东省自然科学基金资助项目(No.2014ZRB14674)

摘　　要：目的:探讨纳美芬联合单唾液酸四己糖神经节苷脂钠用于脑肿瘤手术患者的临床疗效及安全性。方法:64例脑肿瘤手术患者按计算机随机化程序分为观察组和对照组,各32例。对照组患者采用脑细胞保护、降低颅内压、抗感染、扩血管等常规治疗方法;观察组患者在对照组治疗基础上,于术后第1天开始持续静脉泵注纳美芬0.7μg/(kg·h)与单唾液酸四己糖神经节苷脂钠100 mg/d,连续使用7 d。观察两组患者治疗前与治疗后3、7 d血浆皮质醇、促肾上腺皮质激素(ACTH),血清白细胞介素(IL)6、肿瘤坏死因子(TNF)α和巴氏指数(BI)的变化,并观察神经功能改善情况和不良反应发生情况;随访90 d,使用卡氏(KPS)评分评估患者的生活自理能力。结果:治疗后,两组患者血浆皮质醇、ACTH含量及血清TNF-α、IL-6水平均较治疗前显著下降,差异有统计学意义(P<0.05);观察组患者在治疗后3、7 d的皮质醇、ACTH、TNF-α水平,以及治疗后7 d的IL-6水平均较对照组降低得更为明显,差异均有统计学意义(P<0.05)。治疗后,两组患者的BI评分均较治疗前显著提高,且观察组较对照组提高得更为明显,差异均有统计学意义(P<0.05)。治疗后7 d,观察组患者的神经功能改善率为50.00%,明显高于对照组(18.75%),差异有统计学意义(P<0.05)。观察期间,两组患者均未见明显不良反应发生。术后随访90 d,观察组患者KPS评分不低于70分者占比为71.88%,明显高于对照组(46.87%),差异有统计学意义(P<0.05)。结论:纳美芬联合单唾液酸四己糖神经节苷脂钠能促进脑肿瘤患者恢复,降低患者皮质醇、ACTH、IL-6和TNF-α水平,并能改善患者预后。OBJECTIVE：To explore the clinical efficacy and safety of nalmefene combined with monosialotetrahexosylganglioside sodium in the treatment of patients in brain tumor operation. METHODS：64 patients in brain tumor operation were randomly divided into observation group and control group,32 cases in each group. Control group received brain cell protection,reducing intracranial pressure,anti-infective,vasodilator and other conventional treatment;observation group additionally received 0.7 μg/（kg·h）nalmefene combined with 100 mg/d monosialotetrahexosylganglioside sodium from the first day of operation,for continuous 7d. The plasma cortisol,adrenocorticotropic hormone（ACTH）before and 3,7 d after treatment,changes of serum IL-6,TNF-αand Barthel index（BI） in 2 groups were observed,improvement of neurological function and ADR were observed;Karnofsky（KPS）score was determined after 90 d follow-up used to assess the patient＇s ability to take care of themselves. RESULTS：After treatment,plasma cortisol and ACTH content,serum TNF-α and IL-6 levels in 2 groups significantly decreased than before,the difference was statistically significant（P〈0.05）;cortisol,ACTH and TNF-α levels 3,7 d after treatment,IL-6 level 7 d after treatment in observation group decreased more significantly than control group,the differences were statistically significant（P〈0.05）.After treatment,BI score in 2 groups significantly increased,and observation group increased more significantly than control group,the differences were statistically significant（P〈0.05）. 7 d after treatment,improvement rate of neurological function was50.00%,which was significantly higher than that of the control group（18.75%）,the difference was statistically significant（P〈0.05）. There was no significant ADR occurred of 2 groups in the study. Following-up for 90 d,the KPS score in observation group with not less than 70 points accounted for 71.88%,which was significantly higher than the control group（46.87%）,the difference

关 键 词：纳美芬 单唾液酸四己糖神经节苷脂钠 脑肿瘤手术 神经功能 

分 类 号：R749.14[医药卫生—神经病学与精神病学]