低温联合奥拉西坦对重型颅脑损伤患者髓鞘碱性蛋白及胶质纤维酸性蛋白表达的影响  

Effects of hypothermia therapy combined with oxiracetam on expression of MBP and GFAP in patientswith severe traumatic brain injury

作　　者：王光绿 邓峰 潘明远 陈琨 王百欣 莫贻敏 简俊红 WANG Guanglu;DENG Feng;PAN Mingyuan;CHEN Kun;WANG Baix-in;MO Yimin;JIAN Junhong(Department of Neurosurgery,Beihai People′s Hospital,the Ninth Affiliated Hospital of Guangxi Medical University,Beihai 536000,China)

机构地区：[1]广西医科大学第九附属医院北海市人民医院神经外科,广西北海536000

出　　处：《实用医学杂志》2021年第4期502-506,共5页The Journal of Practical Medicine

摘　　要：目的探索低温联合奥拉西坦对重型颅脑损伤患者髓鞘碱性蛋白(MBP)及胶质纤维酸性蛋白(GFAP)表达的影响。方法选取2017年5月至2019年6月我院收治的106例重型颅脑损伤患者,根据入院先后编号,随机将患者分成观察组和对照组,各53例。对照组患者静脉滴注奥拉西坦,观察组患者在对照组的基础上给予低温疗法。对比两组患者颅内压、临床疗效、血清MBP和GFAP及不良反应等指标。结果治疗后,两组患者颅内压值均明显降低,且观察组降低程度更高(P<0.05);两组患者昏迷程度评分明显提高,神经功能评分明显降低,且观察组患者变化程度更高(P<0.05);两组患者血清MBP和GFAP水平明显降低,且观察组患者降低程度更高(P<0.05)。治疗后6个月,观察组患者临床总有效率为71.70%,明显高于对照组的52.83%(χ2=4.015,P=0.045)。治疗期间,两组患者均出现皮疹、腹泻、头晕及发热等不良反应事件,但两组差异无统计学意义(P>0.05)。结论低温联合奥拉西坦可有效改善患者昏迷程度和神经功能,提高临床疗效,下调血清MBP和GFAP,安全有效,值得临床进一步研究并推广。Objective To explore the effects of hypothermia therapy combined with oxiracetam on the expression of MBP and GFAP in patients with severe traumatic brain injury.Methods A total of 106 cases of severe traumatic brain injury patients treated in our hospital from May 2017 to June 2019 were selected and divided into control group and observation group with 53 cases in each group.The patients in the control group were given oxirace⁃tam injection,and those in the observation group were treated with hypothermia therapy in addition to oxiracetam injection.Intracranial pressure,clinical efficacy,serum MBP and GFAP and adverse reactions were compared and analyzed.Results After the treatment,intracranial pressure decreased significantly in both groups,and that in the observation group was higher(P<0.05).Coma score was significantly improved;neurological function score was significantly decreased in the two groups,and the degree of change in the observation group was higher than that in the control group(P<0.05).The levels of serum MBP and GFAP in the two groups were significantly decreased,especially in the observation group(P<0.05).Six months after the treatment,the total clinical effective rate in the observation group was 71.70%,significantly higher than that of 52.83%in the control group(χ^(2)=4.015,P=0.045).During the treatment,adverse reactions such as rash,diarrhea,dizziness and fever occurred in both groups,but there was no significant difference between the two groups(P<0.05).Conclusion Hypothermia combined with oxiracetam can effectively optimize coma and neurological function of patients,improve clinical efficacy and down⁃regulate serum MBP and GFAP.It is safe and effective and worthy of further clinical research and promotion.

关 键 词：低温疗法 奥拉西坦 重型颅脑损伤 髓鞘碱性蛋白 胶质纤维酸性蛋白 

分 类 号：R651.1[医药卫生—外科学]