神经节苷脂对重型颅脑损伤患者血清 S100B 蛋白和Nogo-A 蛋白水平的影响及疗效观 察简

目的 探讨神经节苷脂对重型颅脑损伤患者血清S100B蛋白和Nogo-A蛋白水平的影响及疗效观察.方法 选择2011年1月～2013年5月浙江省萧山中医院脑病中心住院的重型颅脑损伤患者74例,将其随机分为观察组和对照组.两组予以控制颅内压、预防感染、营养脑细胞和预防并发症等治疗,有手术指征者行手术治疗.观察组加用神经节苷脂针100 mg静滴,1次/d,连用2周.观察两组治疗前后血清S100B蛋白和Nogo-A蛋白水平变化,并比较随访3个月后的临床疗效.结果 治疗2周后,两组血清S100B蛋白和Nogo-A蛋白水平（1.15±0.24）、（0.79±0.18）、（181.15 ±42.87）、（109.16±31.92）μg/L]均较治疗前（1.59±0.38）、（1.60±0.41）、（218.02±44.12）、（215.81±50.45） μg/L]明显下降（P＜ 0.05或P＜0.01）,且观察组下降值比对照组更明显（P＜0.05）.治疗后随访3个月,观察组总有效率为86.49％,较对照组的64.86％明显升高（x2=6.19,P＜0.05）.结论 神经节苷脂治疗重型颅脑损伤具有较好效果,作用机制可能与其能降低血清S100B蛋白和Nogo-A蛋白水平密切相关.

Influence and curative effect observation of ganglioside on serum S100B protein and Nogo-A protein levels of patients with severe head injury

Objective To discuss influence and curative effect observation of Ganglioside on serum S100B protein and Nogo-A protein levels of patients with severe head injury.Methods 74 cases of patients with severe head injury,who were in Encephalopathy Center of Xiaoshan Traditional Chinese Medicine Hospital from January 2011 to May 2013 were divided into observation group and control group at random.The patients in two groups were given the medical treatment like intracranial pressure control,infection protection,brain cells nutrition,complication prevention and etc.,and the patients with operation indications were given the operation.The patients in observation group were additional ly given 100 mg ganglioside by intravenous infusion once a day for 2 weeks.The changes of serum S100B protein and Nogo-A protein levels of patients in two groups before and after medical treatment were observed,and the clinical curative effect after 3 months＇ following-up was compared as well.Results After medical treatment for 2 weeks,serum S100B protein and Nogo-A protein levels of patients in two groups （1.15±0.24）,（0.79±0.18）,（181.15±42.87）,（109.16± 31.92） μg/L] declined obviously than before （1.59±0.38）,（1.60±0.41）,（218.02±44.12）,（215.81±50.45） μg/L] （P 〈 0.05 or P 〈 0.01）,and the declining rate of patients in observation group was much higher than that in control group （P 〈 0.05）.After medical treatment,following-up for 3 months,total clinical efficiency of patients in observation group （86.49%） was much higher than that in control group （64.86%） （x 2=6.19,P 〈 0.05）.Conclusion Ganglioside has a reliable curative effect on severe head injury,whose mechanism has close effect on reducing serum S100B protein and Nogo-A protein levels.