CAJ | 학술논문

目的探讨高压氧(HBO)治疗重度闭合性颅脑损伤(TBI)患者的临床疗效和依达拉奉的干预作用.方法 42例TBI患者,随机分为两组,HBO治疗组21例,行HBO 和其他常规治疗;依达拉奉干预组(EB干预组)21例,在HBO 和其他常规治疗基础上加用依达拉奉;另选12例健康志愿者为正常对照组.于治疗前、治疗14 d后行格拉斯哥昏迷评分(GCS)并检测血清丙二醛(MDA)、蛋白质氧化硝基化指标3-硝基酪氨酸(3-nitrotynosine,3-NT)水平及抗氧化酶铜、锌离子超氧化物歧化酶(CuZn-superoxide dismutase,CuZn-SOD)和谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-px)的活力变化,病程3个月时行格拉斯哥预后评分(GOS).结果治疗前HBO治疗组和EB干预组的GCS、血清MDA、3-NT水平及CuZn-SOD、GSH-px活力间差异无统计学意义(P＞0.05),但与正常对照组比较差异均有统计学意义(P＜0.01);而治疗后HBO治疗组和EB干预组上述各指标间差异均有统计学意义(P＜0.05),病程3个月时两组患者GOS间差别亦有统计学意义(P＜0.05).结论依达拉奉联合HBO治疗重度闭合性TBI的疗效优于单纯HBO治疗.
목적 탐토고압양(HBO)치료중도폐합성로뇌손상(TBI)환자적림상료효화의체랍봉적간예작용.방법 42례TBI환자,수궤분위량조,HBO치료조21례,행HBO 화기타상규치료;의체랍봉간예조(EB간예조)21례,재HBO 화기타상규치료기출상가용의체랍봉;령선12례건강지원자위정상대조조.우치료전、치료14 d후행격랍사가혼미평분(GCS)병검측혈청병이철(MDA)、단백질양화초기화지표3-초기락안산(3-nitrotynosine,3-NT)수평급항양화매동、자리자초양화물기화매(CuZn-superoxide dismutase,CuZn-SOD)화곡광감태과양화물매(glutathione peroxidase,GSH-px)적활력변화,병정3개월시행격랍사가예후평분(GOS).결과 치료전HBO치료조화EB간예조적GCS、혈청MDA、3-NT수평급CuZn-SOD、GSH-px활력간차이무통계학의의(P＞0.05),단여정상대조조비교차이균유통계학의의(P＜0.01);이치료후HBO치료조화EB간예조상술각지표간차이균유통계학의의(P＜0.05),병정3개월시량조환자GOS간차별역유통계학의의(P＜0.05).결론 의체랍봉연합HBO치료중도폐합성TBI적료효우우단순HBO치료.
Objective To observe the therapeutic effects of hyperbaric oxygenation (HBO) combined with edaravone,a potent scavenger of hydroxyl radicals,on severe closed traumatic brain injury(TBI).Methods Forty-two patients were randomized into groups HBO and HBO+EB (receiving treatment of HBO and edarayone),21 in each.Another 12 healthy volunteers were chosen as normal controls.Before treatment and after 14 d of treatment,Glasgow Coma Scores (GCS) were performed and Malondialdehyde(MDA),3-nitrnosine(3-NT),CuZn-superoxide dismutase(CuZn-SOD)and glutathione peroxidase(GSH-px)were detected in 2 treatment groups.After 3 months,Glasgow Outcome Scales (GOS) were performed.Results There were not significant differences in levels of GCS,MDA,3-NT and activities of CuZn-SOD,GSH-px between groups HBO and HBO+EB before treatment (P＞0.05),but there were between 2 treatment groups and control (P＜0.01).After treatment,significant difference was noted in levels of GCS,MDA,3-NT and activities of CuZn-SOD,GSH-px,and in GOS at months 3 between groups HBO and HBO+EB(P＜0.05).Conclusion HBO+EB is superior to HBO in treatment of severe closed TBI.