基于PI3K/Akt通路探讨醒脑静注射液改善颅脑创伤患者神经损伤及预后的效果  

Effect of Xingnaojing injection on improving nerve injury and prognosis of patients with craniocerebral trauma based on PI3K/Akt pathway

作　　者：邵婷[1] 黄从刚[1] 王远[1] 罗志华[1] SHAO Ting;HUANG Conggang;WANG Yuan;LUO Zhihua(Wuhan No.1 Hospital,Wuhan 430022,China)

机构地区：[1]武汉市第一医院,湖北武汉430022

出　　处：《中国实用神经疾病杂志》2024年第11期1342-1346,共5页Chinese Journal of Practical Nervous Diseases

基　　金：湖北省科技厅自然科学基金计划项目(编号:2023AFB1051)。

摘　　要：目的基于磷酸肌醇-3-激酶/丝氨酸/苏氨酸蛋白激酶(PI3K/Akt)通路探讨醒脑静注射液治疗颅脑创伤患者的效果,分析其对神经损伤、预后的影响。方法选取2020-06—2023-06武汉市第一医院收治的96例颅脑创伤患者,分为对照组48例(常规治疗)和观察组48例(常规治疗+醒脑静注射液治疗)。比较2组治疗效果、治疗前后PI3K/Akt通路分子[外周血单个核细胞(PMBC)中PI3K、Akt、哺乳动物雷帕霉素靶蛋白(mTOR)mRNA]、神经损伤因子、神经损伤程度[中国脑卒中临床神经功能缺损程度评分量表(CSS)、美国国立卫生研究院卒中量表(NIHSS)、格拉斯哥昏迷量表(GCS)评分],以及并发症发生率、预后情况。结果与对照组比较,观察组总有效率升高,并发症发生率降低(P<0.05)。观察组治疗7 d、14 d后PI3K、Akt、mTOR mRNA相对表达量升高(P<0.05),血清神经元特异性烯醇化酶(NSE)、胶质纤维酸性蛋白(GFAP)、S-100β蛋白(S-100β)、髓鞘碱性蛋白(MBP)水平降低(P<0.05),CSS、NIHSS评分降低,GCS评分升高(P<0.05)。治疗后3个月观察组预后良好率升高(P<0.05)。结论醒脑静注射液治疗颅脑创伤患者的疗效确切,可促进神经功能恢复,减少并发症,并可改善患者预后,其作用机制可能与激活PI3K/Akt通路有关。Objective To investigate the therapeutic effect of Xingnaojing injection on patients with craniocerebral trauma based on phosphoinositol-3-kinase/serine/threonine protein kinase(PI3K/Akt)pathway,and analyze its influence on nerve injury and prognosis.Methods A total of 96 patients with head trauma admitted to Wuhan No.1 Hospital from June 2020 to June 2023 were selected and were divided into control group(48 cases,conventional treatment)and observation group(48 cases,conventional treatment+awakening brain injection treatment).The therapeutic effect,PI3K/Akt pathway molecules(PI3K in peripheral blood mononuclear cells(PMBC),Akt,mammalian target of rapamycin(mTOR)mRNA),nerve injury factors,nerve injury degree(Chinese stroke clinical neurological deficit score(CSS),National Institutes of Health stroke scale(NIHSS),Glasgow coma scale(GCS)scores)before and after treatment,as well as the incidence of complications and prognosis were compared between the two groups.Results Compared with the control group,the total effective rate of observation group was increased and the complication rate was decreased(P<0.05).After 7 days and 14 days of treatment,the relative mRNA expressions of PI3K,Akt and mTOR increased(P<0.05),and the serum levels of neuron-specific enolase(NSE),glial fibrillary acidic protein(GFAP),S-100βprotein(S-100β)and myelin basic protein(MBP)decreased(P<0.05).The scores of CSS and NIHSS decreased(P<0.05),the GCS score increased(P<0.05),and the prognosis rate of the observation group increased at 3 months after treatment(P<0.05).Conclusion Xingnaojing injection is effective in the treatment of patients with craniocerebral trauma.It can promote the recovery of nerve function,reduce the occurrence of complications,and improve the prognosis.The mechanism of action may be related to the activation of PI3K/Akt pathway.

关 键 词：颅脑创伤 醒脑静注射液 磷酸肌醇-3-激酶/丝氨酸/苏氨酸蛋白激酶通路 神经功能 预后 

分 类 号：R651.15[医药卫生—外科学]