单唾液酸四己糖神经节苷脂对重型颅脑损伤患者血清超敏 C 反应蛋白、白介素-6 和肿瘤坏死因子-α 水平的影响及疗效观察

目的 探讨单唾液酸四己糖神经节苷脂对重型颅脑损伤患者血清超敏C反应蛋白（hs-CRP）、白介素（IL）-6和肿瘤坏死因子（TNF）-α水平的影响及疗效观察.方法 选取2011年1月～2013年2月浙江省天台县人民医院ICU住院治疗的重型颅脑损伤患者78例,随机分为观察组39例和对照组39例.两组均予以降颅压、抗感染、亚低温治疗和预防并发症等常规治疗.观察组加用单唾液酸四己糖神经节苷脂静滴100 mg/次,1次/d,连用14 d.观察两组治疗前和治疗14 d后血清hs-CRP、IL-6和TNF-α水平的变化,并随访治疗后2个月的临床效果.结果 两组治疗前血清hs-CRP、IL-6和TNF-α水平比较差异无统计学意义（t=0.08、0.09、0.13,P＞0.05）.治疗14 d后,两组血清hs-CRP、IL-6和TNF-α水平对照组（16.38±4.23）μg/L、（32.16±8.76）μg/L、（14.57±4.12）μg/L;观察组（11.45±3.12）μg/L、（21.15±7.24）μg/L、（9.14±2.76） μg/L]均较治疗前对照组（23.12±6.15）μg/L、（47.86±10.16）μg/L、（19.82±5.68） μg/L;观察组（22.94±6.48） μg/L、（48.07±9.79）μg/L、（20.05±6.04）μg/L]明显下降,差异有统计学意义（P＜ 0.05或P＜0.01）;且观察组治疗14 d后hs-CRP、IL-6和TNF-α水平明显低于对照组,差异均有统计学意义（P＜0.05）.随访2个月,观察组临床总有效率（89.74％）明显高于对照组（69.23％）,差异有统计学意义（x2=5.03,P＜ 0.05）.结论 单唾液酸四己糖神经节苷脂用于重型颅脑损伤具有较好效果,作用与其降低血清hs-CRP、IL-6和TNF-α水平密切相关.

Influence and curative effect observation of Monosialoteterahexosyl Ganglioside on serum high sensitivity C reactive protein,interleukin-6 and tumor necrosis factor-α of patients with severe head injury

Objective To discuss influence and curative effect observation of Monosialotetrahexosyl Ganglioside on serum high sensitivity C reactive protein （hs-CRP）,interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α） of patients with severe head injury.Methods 78 cases with severe head injury in Department of ICU,People＇s Hospital of Tiantai County from January 2011 to February 2013 were selected and divided into observation group （39 cases） and control group （39 cases） randomly.The patients in two groups were given routine medical treatment like lowering the intracranial pressure,anti-infection,hypothermia treatment,complication prevention.The patients in observation group were additionally given Monosialotetrahexosyl Ganglioside by intravenous infusion,100 mg/time,1 time/d for 14 days.The serum hs-CRP,IL-6 and TNF-α levels of patients in two groups before and 14 days after the medical treatment were observed,and clinical curative effect after 2 months＇ medical treatment was followed up.Results The differences of hs-CRP,IL-6,TNF-α in the two groups before the treatment were not statistically significant （t =0.08,0.09,0.13,P ＞ 0.05）.After 14 days＇ medical treatment,serum hs-CRP,IL-6 and TNF-α levels of patients in two groups control group （16.38±4.23） μg/L,（32.16±8.76） μg/L,（14.57±4.12） μg/L; observation group （11.45±3.12） μg/L,（21.15±7.24） μg/L,（9.14±2.76） μg/L] were obviously lower than those before the treatment control group （23.12±6.15） μg/L,（47.86±10.t6） μg/L,（19.82±5.68） μg/L; observation group （22.94±6.48） μg/L,（48.07±9.79） μg/L,（20.05±6.04） μg/L],the differences were statistically significant （P ＜ 0.05 or P ＜ 0.01）; the hs-CRP,IL-6,TNF-α in observation group 14 days after the treatment were all lower than those in control group,the differences were statistically significant （P ＜ 0.05）.After 2 months＇ following-up,the total clinical efficiency of patients in observation group （89.74％） was much higher than that in control group （69.23％）,the difference was statistically significant （x2 =5.03,P ＜ 0.05）.Conclusion Monosialotetrahexosyl Ganglioside has reliable curative effect on severe head injury,whose mechanism of action has close effect on reducing serum hs-CRP,IL-6 and TNF-α levels.