CAJ | 학술논문

目的：探讨神经节苷脂治疗急性脑出血的疗效及对血清 IL-1β、IL-6、IL-8水平的影响。方法选取2011年1月-2013年12月在本院神经科住院治疗的急性脑出血患者76例，采用数字表随机抽取法将入选患者分为观察组和对照组，每组38例。2组患者均予以酌情降颅压和血压、止血、抗感染和营养脑细胞等常规治疗，观察组患者加用神经节苷脂针60 mg静滴，1次/d，对照组患者加用孢磷胆碱钠针0．5g静滴，1次/d，2组均连用10d。观察2组患者治疗前后血清IL-1β、IL-6、IL-8水平的变化，并比较其临床疗效及药物不良反应。结果治疗10 d 后，2组患者血清 IL-1β、IL-6、IL-8水平较治疗前明显下降（P ＜0．05或P ＜0．01），且观察组下降幅度较对照组更明显（P ＜0．05）；观察组患者临床总有效率明显高于对照组（94．74％与78．95％，χ2＝4．15，P ＜0．05）；对照组和观察组治疗中出现不良反应分别为2和4例，症状较轻，无严重的药物不良反应发生，2组患者不良反应发生率比较差异无统计学意义（χ2＝0．18，P ＞0．05）。结论神经节苷脂治疗急性脑出血效果满意，安全性较好。作用机制可能为通过降低血清 IL-1β、IL-6、IL-8水平，抑制局部炎症反应而发挥对脑出血后继发脑损伤保护作用。
목적：탐토신경절감지치료급성뇌출혈적료효급대혈청 IL-1β、IL-6、IL-8수평적영향。방법선취2011년1월-2013년12월재본원신경과주원치료적급성뇌출혈환자76례，채용수자표수궤추취법장입선환자분위관찰조화대조조，매조38례。2조환자균여이작정강로압화혈압、지혈、항감염화영양뇌세포등상규치료，관찰조환자가용신경절감지침60 mg정적，1차/d，대조조환자가용포린담감납침0．5g정적，1차/d，2조균련용10d。관찰2조환자치료전후혈청IL-1β、IL-6、IL-8수평적변화，병비교기림상료효급약물불량반응。결과치료10 d 후，2조환자혈청 IL-1β、IL-6、IL-8수평교치료전명현하강（P ＜0．05혹P ＜0．01），차관찰조하강폭도교대조조경명현（P ＜0．05）；관찰조환자림상총유효솔명현고우대조조（94．74％여78．95％，χ2＝4．15，P ＜0．05）；대조조화관찰조치료중출현불량반응분별위2화4례，증상교경，무엄중적약물불량반응발생，2조환자불량반응발생솔비교차이무통계학의의（χ2＝0．18，P ＞0．05）。결론신경절감지치료급성뇌출혈효과만의，안전성교호。작용궤제가능위통과강저혈청 IL-1β、IL-6、IL-8수평，억제국부염증반응이발휘대뇌출혈후계발뇌손상보호작용。
Objective To discuss curative effect of Ganglioside on acute intracerebral hem-orrhage (AICH)and its influence on serum interleukin-1β,IL-6 and IL-8 levels.Methods 76 pa-tients with AICH were divided into observation group and control group by random digital table method with 38 patients in each group.The patients in two groups were given routine medical treatment,such as reducing intracranial pressure and blood pressure,hemostasis,anti-infection, brain cells nutrition and so on.The patients in observation group were additionally given 60 mg Ganglioside by intravenous infusion for once a day,while the patients in control group were addi-tionally given 0.5 g Citicoline Sodium Injection by intravenous infusion,once a day for 10 days. The changes of serum IL-1β,IL-6 and IL-8 levels of patients in two groups before and after medi-cal treatment were observed,and the clinical curative effect and drug adverse reaction (DAR)were compared as well.Results After 10 days′medical treatment,the serum IL-1β,IL-6 and IL-8 lev-els of patients in two groups obviously declined than before (P <0.05 and P <0.01),and the de-clining rate in observation group was much higher than that in control group (P <0.05).The total clinical efficiency of patients in observation group was much higher than that in control group (94.74% vs.78.95%)(χ2=4.15,P <0.05).Adverse effect appeared in 2 and 4 patients in control group and observation group respectively during the medical treatment with light symptom and no serious DAR.After comparing the occurrence rates of adverse effect of patients in two groups,there was no statistical differences (χ2=0.18,P >0.05).Conclusion Ganglioside has favorable curative effect on AICH with high security,whose mechanism of action may inhibit lo-cal inflammatory response to protect the secondary brain injury after intracerebral hemorrhage by reducing the serum serum IL-1β,IL-6 and IL-8 levels.