参附注射液对创伤性心脏骤停脑损伤保护作用的临床研究  

Clinical Efficacy Observation of Shenfu Injection on Brain Injury Protection in Traumatic Cardiac Arrest

作　　者：颜宁钟 邓海霞 蓝洲 雷志强 陀鹏 甘仁 吴鑫宇 肖佳佳 Yan Ningzhong;Deng Haixia;Lan Zhou;Lei Zhiqiang;Tuo Peng;Gan Ren;Wu Xinyu;Xiao Jiajia(The First Affiliated Hospital of Guangxi University of Chinese Medicine,Guangxi,Nanning 530022,China)

机构地区：[1]广西中医院大学第一附属医院,广西南宁530022 [2]广西中医药大学,广西南宁530200

出　　处：《中国中医急症》2024年第10期1709-1711,1733,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：2021年广西自然科学基金项目面上项目(2021JJA141283)。

摘　　要：目的 观察参附注射液治疗创伤性心脏骤停(TCA)脑损伤的临床疗效,并对其在脑保护的作用效果进行分析。方法 选取广西中医药大学第一附属医院于2018年1月至2023年7月收治的36例TCA后恢复自主循环(ROSC)患者作为研究对象,并随机分为治疗组与对照组各18例。两组均给予常规重症支持治疗,治疗组在此基础上联合使用参附注射液,采用酶联免疫吸附法和电化学发光免疫分析技术分别测定并比较两组ROSC后2、24、48、72 h血清S-100β蛋白、神经元特异性烯醇化酶(NSE)水平。在ROSC后2、24、48、72 h使用格拉斯哥昏迷量表(GCS)对两组患者进行评分,同时记录复苏有效率及存活率。结果 ROSC后两组患者的复苏有效率比较,治疗组为61.11%,明显高于对照组的38.89%(P <0.05);两组存活率比较,治疗组为33.33%,明显高于对照组的5.56%(P <0.05);两组ROSC后的S-100β蛋白和NSE水平均明显升高(P <0.05);在ROSC后24、48、72 h,治疗组S-100β蛋白、NSE水平逐渐下降,与对照组同期水平相比明显降低(P <0.05);两组GCS评分在ROSC后明显升高(P <0.05);对照组与治疗组相比,在ROSC后48、72 h,治疗组GCS评分高于对照组(P <0.05)。结论 在常规复苏基础上加用参附注射液治疗,可以有效提高TCA脑损伤患者的疗效并改善预后。Objective:To observe the clinical efficacy of Shenfu Injection in treating brain injury caused by trau-matic cardiac arrest(TCA),and to analyze its effect on brain protection.Methods:A total of 36 patients with re-turn of spontaneous circulation(ROSC)after TCA admitted to the First Affiliated Hospital of Guangxi University of Chinese Medicine from January 2018 to July 2023 were selected as study subjects and were randomly divided into a treatment group and control group,with 18 cases in each group.Both groups received conventional intensive support treatment,while the treatment group was additionally administered Shenfu Injection.The serum levels of S-100βprotein and neuron-specific enolase(NSE)were measured and compared between the two groups at 2,24,48,and 72 hours after ROSC using enzyme-linked immunosorbent assay(ELISA)and electrochemiluminescence immunoassay,respectively.Glasgow Coma Scale(GCS)scores were recorded for both groups at 2,24,48,and 72 hours after ROSC,along with the resuscitation success rate and survival rate.Results:The resuscitation success rate of the treatment group was 61.11%,significantly higher than that of the control group(38.89%)(P<0.05);the survival rate of the treatment group was 33.33%,also significantly higher than that of the control group(5.56%)(P<0.05).Serum S-100βprotein and NSE levels increased significantly in both groups after ROSC(P<0.05).At 24,48,and 72 hours after ROSC,the S-100βprotein and NSE levels in the treatment group gradually de-creased and were significantly lower compared to the control group(P<0.05).GCS scores increased significantly post-ROSC in both groups(P<0.05),with the treatment group scoring higher than the control group at 48 and 72 hours post-ROSC(P<0.05).Conclusion:Administration of Shenfu Injection in addition to conventional resuscita-tion can effectively improve the therapeutic efficacy and prognosis of patients with brain injury due to TCA.

关 键 词：创伤性心脏骤停 参附注射液 S-100Β 神经元特异性烯醇化酶 脑损伤 

分 类 号：R541.7[医药卫生—心血管疾病]