依达拉奉对中、重型颅脑外伤患者血清神经元特异性烯醇化酶和S100β蛋白浓度的影响

目的 探讨新型氧自由基清除剂依达拉奉对中、重型颅脑外伤患者血清神经元特异性烯醇化酶(neuron-specific enolase,NSE)和S100β蛋白浓度的影响.方法 选取中、重型颅脑外伤手术患者90例,将患者分为对照组(A组)、手术后应用依达拉奉组(B组)和手术前应用依达拉奉组(C组),各组30例,同时取门诊健康体检者20例作为健康对照组.采用ELISA法测定各组入院时以及手术后1,3,5,7 d外周静脉血血清NSE和S100β浓度.结果 A组、B组租C组患者血清NSE和S100β蛋白浓度在入院时及手术后1,3,5,7 d明显高于健康对照组,并在手术后第1天达高峰(P＜0.05).术后第1天,C组与对照组、A组、B组比较,血清NSE和S100β蛋白浓度降低(P＜0.05);A组与B组之间差异无统计学意义(P＞0.05).术后第3,5,7天,C组与A组比较,血清NSE和S100β蛋白浓度降低(P＜0.05);C组与B组比较,重型患者血清NSE和S100β蛋白浓度降低(P＜0.05),但中型患者血清NSE和S100β蛋白浓度差异无统计学意义(P＞0.05);B组与A组比较,血清NSE和S100β蛋白浓度降低(P＜0.05).结论 依达拉奉能有效降低中、重型颅脑外伤手术患者血清NSE和S100β蛋白浓度,越早使用降低越明显,特别是对于重型颅脑外伤手术患者,手术前应用依达拉奉能更有效地降低血清NSE和S100β蛋白浓度.

Abstract：

Objective To evaluate the effect of edaravone on moderate and severe brain injury patients by observing the change of the serum neuron-specific enolase ( NSE) and S100β protein. Methods A total of 90 patients with acute moderate and severe brain injury were selected and randomly divided into three groups, ie, control group (Group A), postoperative edaravone treatment group (Group B) and preoperative edaravone treatment group (Group C), 30 patients per group. In the meantime, 20 normal persons were set as the healthy control group. The concentrations of serum NSE and S100β protein of each group was measured by using the enzyme-linked immunosorbent assay ( ELISA) on admission and at days 1,3,5 and 7 after operation. Results The serum NSE and S100β protein levels in the Group A, B and C was higher than that in the healthy group on admission and at days 1,3,5 and 7 postoperatively and reached the peak at day 1 after operation (P ＜0.05). The level of serum NSE and S100β protein in the Group C was lower than that in the healthy group, Group A and Group B at day 1 postoperatively (P＜0.05), with no statistical difference between Group B and Group A at day 1 postoperatively (P ＞0.05). The serum NSE and S100β protein levels in the Group C was lower than that in the Group A at days 3, 5 and 7 postoperatively (P ＜0.05). The serum NSE and S100β protein levels in the Group C with severe brain injury was lower than that in the Group B at days 3, 5 and 7 postoperatively (P ＜ 0.05), but there was no statistical difference in moderate injury group between Croup C and Group B. The serum NSE and S100β levels in the Group B was lower than that in the Group A at days 3, 5 and 7 postoperatively ( P ＜ 0. 05). Conclusions Edaravone can effectively reduce the serum NSE and S100β levels in the moderate and severe brain injury patients after operation. The earlier use of edaravone may beget the more significant effect, especially in patients with severe brain injury. The application of edaravone before operation can more effectively reduce the concentration of serum NSE and S100β protein.